Single-stage Ureteroscopic Ho:YAG Laser Lithotripsy for Multiple and Bilateral Ureteral Stones

Single-stage Ureteroscopic Ho:YAG Laser Lithotripsy for Multiple and Bilateral Ureteral Stones
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Title:Single-stage Ureteroscopic Ho:YAG Laser Lithotripsy for Multiple and Bilateral Ureteral Stones
Author/Abstract:

Noel Zachary S. Recidoro, MD and Jose Benito A. Abraham, MD, FPUA
Department of Urology, National Kidney and Transplant Institute

Multiple and bilateral ureteral stones pose therapeutic challenges to the urologist. The authors we
reviewed their experience with single-stage ureteroscopic Ho:YAG intracorporeal laser lithotripsy
(ICL) as monotherapy for patients with bilateral obstructive and multiple unilateral ureteral calculi.

Methodology: A retrospective chart review was done on all patients diagnosed with multiple unilateral
or bilateral ureteral calculi from July 2009 to May 2012. All stones were diagnosed using a helical
unenhanced CT scan. A 9.5Fr semi-rigid ureteroscope (Storz®) was used and intracorporeal lithotripsy
was performed using a Ho-YAG laser machine (Sphinx®) by urologists of varying experiences in a
single institution. Stone-free status was defined as total stone residual of < 3mm. based on a repeat
ultrasound or CT scan.

Results: A total of 63 patients diagnosed with multiple unilateral (45) or bilateral (18) ureteral
stones.
The mean stone number per patient was 2.46±1.71 and the mean stone burden was 1.36±0.91cm.
The mean operative time was 88.62±75.40mins. The over-all stone-free rate after a single session
was 98%. The stone-free rate after a repeat ureteroscopy was 100%. Thirteen patients (21%) developed fever (Clavien 1) and one patient (1%) developed died of uremic complications (Clavien 5).

Conclusion: Ureteroscopic Ho:YAG laser lithotripsy is effective as monotherapy for multiple or
bilateral stones with an acceptable low complication rate.

Key words: Holmium YAG laser, ureteroscopy, multiple and bilateral ureterolithiases

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