Analysis Of The Failure Causes Of Ureteroscopic Lithotripsy

Objective To compare the failure rate and causes of ureteroscopic pneumatic lithotripsy (PL) and ureteroscopic holmium laser lithotripsy (LL) for ureteral stones.Methods From Apr. 1999 to Nov. 2003, 320 consecutive patients underwent endoscopic lithotripsy either with the Wolf Lithoclast pneumatic lithotripter (110 cases) or with Ho:YAG laser lithotripter (210 cases) for the treatment of ureteral stones. The failure rate and the causes of failure were compared.Results The failure rate of the PL was significantly higher than those of LL (30.9% vs 15.2%, P<0.01). The failure rate due to fragments that had been propelled into the kidney was higher in PL than that in LL(11.8% vs 4.8%, P<0.05).21 patients and 66 patients with ureteral stones which combined with ureter obstruction underwent PL and LL respectively .The failure rate was higher in PL than that in LL(57.1% vs 21.2%, P<0.05). 3 patients (2.7%) encounted perforation in PL procedure, whereas 4 patients (1.9%) occurred perforation when underwent LL , there was no significant difference(P>0.05).Conclusions LL is superior to PL for ureteroscopic lithotripsy. Comparing to PL, LL is a safer and more effective procedure for ureteral stones.