Ureteral Calculi Treated With Transureteroscopic Holmium: YAG Laser Lithotripsy

Objective To evaluate the efficiency and the prevention of complication of transureteroscopic Holmium:YAG laser lithotripsy on ureteral calculi.Methods From June 2003 to July 2008,382 cases of ureteral stones treated by transureteroscopic Homlium:YAG laser lithotripsy in our single center were retrospectively analyzed.Result Of 382 cases, the overall successful rate in a single procedure was 92.93%(355/382). The successful rates of fragmentation in a single procedure for the upper, middle and lower levels of ureteral stones were 84.35%(97/115), 91.49%(43/47)and 97.73%(215/220),respectively.27 patients failed on the first lithotripsy.8 of them were failed due to the stones returning to the kidney and were treated with extracorporeal shock wave lithoripsy (ESWL) later after placement of Double-J stent. There were 17 cases failed to insert the ureteroscope. 13 of them cases failed owing to the stenosis of the ureter. 2 cases were halted due to the tortuosity of ureter and 2 cases failed due to the ureteral mucosa dropsy.15 of them chose for lithotomy and the other 2 cases received ESWL treatment. 2 cases were transferred to open surgery because of a lot of grenulation tissue and floccule.Generally, complications occurred in 6 cases. 4 of them had feve(rT>39℃)after surgery, 3 cases were cured after antimicrobial therapy,1 case had septic shock and was cured after the treatment of antiinfection and antishock.The other 2 cases were encountered ureter perforation and latterally were cured after placing double-J tube. The mean operative time was 45 min. The average hospitalization time was 4.5d.Conclusions The transureteroscopic Holmium:YAG laser lithotripsy has the advantages of minimal invasion, safety,efficiency and low incidence of complication.