HOLMIUM LASER LITHOTRIPSY FOR URETERAL CALCULI - AN OUTPATIENT PROCEDURE

A retrospective review was conducted to evaluate the efficacy of urete roscopic lithotripsy using the holmium laser with a semirigid endoscop e in a newly established day surgery center. In 1996, 69 consecutive p atients (40 male and 29 female) with a mean age of 46.7 (range 21-73) years and ASA status I or II underwent ureteroscopic lithotripsy for t heir ureteral calculi using the holmium laser (365-mu m fiber; power s etting 0.5-1.4 J/5 Hz) and 8,5F semirigid ureteroscope in a day surger y setting. Stone features, postoperative pain scores, readmissions, an d complications were evaluated. Eighteen upper, 17 middle, and 34 lowe r ureteral stones were treated, with a mean size measuring 12.1 (5-45) mm, The mean operative time was 61 minutes including the anesthetic t ime (range 15-150 minutes), and the success rate was 91% (63/69), The complication rate was 10% (7/69) including four unscheduled readmissio ns (6%), Telephone follow-up on postoperative Day 1 and Day 3 revealed mean pain scores of 2 and 1, respectively (on a 0-10 scale) and an an algesic requirement of 1 tablet of Dologesic (containing 32.5 mg of de xtropropoxyphene +320 mg of paracetamol) four times a day on both days . Ureteroscopic lithotripsy using the holmium laser and a semirigid en doscope is highly successful and well tolerated and carries a low comp lication rate. It is indicated as an ambulatory and minimally invasive treatment modality in low-risk patients with ureteral stones.