Lasertripsy of Upper Urinary Tract Calculi after Unsuccessful Extracorporeal Lithotripsy or Ureteroscopy: Comparison with Primary Lasertripsy

Division of Urology, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey.
Journal of Endourology (Impact Factor: 1.71). 01/1994; 7(6):473-6. DOI: 10.1089/end.1993.7.473
Source: PubMed


Lasertripsy of upper urinary tract calculi after unsuccessful extracorporeal lithotripsy (SWL) or ureteroscopy (Group 1; N = 26 patients, 36 calculi) was compared with primary lasertripsy (Group 2; N = 56 patients, 79 calculi). Access to calculi was achieved by a Candela miniscope or flexible ureteroscope, and laser fragmentation was performed with the Candela pulsed-dye laser. Laser alone or laser plus 1.9F basket extraction produced a stone-free rate of 80.6% in Group 1 and 79.8% in Group 2. Additional treatment methods were needed in similar proportions of both groups and in most patients consisted of SWL of fragments displaced into the kidney. The laser fragmentation failures rates were 2.8% in Group 1 and 7.6% in Group 2. One-month stone-free rates and major complication rates were similar in the two groups. Lasertripsy after unsuccessful SWL or ureteroscopy was as effective as primary lasertripsy.

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    • "It is also difficult to fragment very hard stones with ultrasound. A solid wire ultrasound probe has also been described [3]. It requires a straight channel significantly larger than the probe itself to leave room for movement with the vibration of the probe. "
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    ABSTRACT: There is a wide array of endoscopic lithotriptors presently available. Each of these has its own advantages and disadvantages. No single lithotriptor is suitable for all applications and none can meet the goal of fragmenting all calculi while remaining harmless to tissue.
    Diagnostic and Therapeutic Endoscopy 02/1997; 4(1):1-7. DOI:10.1155/DTE.4.1
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    ABSTRACT: Laser lithotripsy with mini-ureteroscopes is a minimally invasive method to fragment ureteral calculi. This study reviewed the efficacy and morbidity of outpatient laser lithotripsy for the treatment of ureteral calculi. The 248 patients were initially treated by outpatient ureteroscopy and laser lithotripsy with the Candela pulsed-dye laser over a period of 3 1/2 years. Thirty-six patients had prior unsuccessful fragmentation of ureteral calculi by SWL. Twenty-eight patients had undergone unsuccessful ureteroscopy with attempted basket extraction or attempted fragmentation with methods other than laser. Calculi were located in the upper ureter in 31% and in lower ureter in 69% of these patients. The 1-month stone-free rate was 92% for upper ureteral calculi and 96% for lower ureteral calculi, with an overall success rate of 94.7%. Ninety per cent of the patients were discharged the same day and 96% within 23 hours. Hospital admission was needed in only 4% of patients. Parenteral analgesia was required in 18% of patients, and major complications occurred in 0.8%. The combination of mini-ureteroscopes and laser lithotripsy is an effective method for fragmentation of ureteral calculi in outpatients with low morbidity and few complications.
    Journal of Endourology 11/1994; 8(5):341-3. DOI:10.1089/end.1994.8.341 · 1.71 Impact Factor
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    Journal of Endourology 03/1996; 10(1):27-30. DOI:10.1089/end.1996.10.27 · 1.71 Impact Factor
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