LASER-INDUCED LITHOTRIPSY OF URETERAL CAL CULI

A total of 149 patients with 152 ureteral stones were treated with int raureteral lithotripsy by Dye-laser (83.55 %), Alexandrite-laser (41.2 7 %), electrohydraulic lithotripsy adapted for use in the ureter (25.1 6 %) or neodymium: YAG laser with optomechanic coupling (3.2 %). The D ye-laser has an automatic pulse shut-off mechanism with spectral analy sis of the reflected laser beam, so that effective laser pulses can on ly be released by contact with a stone. Most (127 of 83.5 %) of the st ones could be completely fragmented, so that no further treatment was necessary. In 16 cases (10.5 %) the stone was too hard for fragmentati on and had to be removed by alternative techniques. Intraureteral lith otripsy is a save and effective method of treating ureteral stones tha t cannot be reached or have not been treated successfully by schockwav e lithotripsy. No significant differences in outcome were found betwee n the different lasers or electro-hydraulic lithotripsy. In selected c ases endoscopic treatment may be recommended as treatment of first cho ice.