Endoscopic Treatment of Complex Ureteral Calculi Using Ultrasound and Laser Contact Ureteral Lithotripsy

Nowadays contact ureteral lithotripsy with the use of semi-rigid ureteroscope is the method of choice for the urologist in the treatment of ureteral calculi. It is possible to use both the ultrasonic and laser lithotripter. Materials and methods. Comparative analysis of the duration of lithotripsy various stages was conducted with the use of ultrasound and laser lithotripters based on video recording analysis. Thus, we compared the chronometry results in 23 patients with the calculi up to 1 cm in size and density of no more than 1000 Hounsfield units (conventionally we named them “standard” calculi) and in 18 patients with complex calculi localized in the lower third of the ureter during the treatment with the use of ultrasound contact lithotripsy. Results of the research. Total duration of the surgery was the lowest in patients with complex calculi up to 1 cm in size with the use of laser ureteral lithotripsy and constituted 11.31 ± 0.85 minutes. Duration of the surgery in patients with “standard” calculi amounted 14.20 ± 1.15 minutes on average being significantly greater (p< 0.5) than in the previous group. Duration of the surgery in patients in the group with complex calculi larger than 1.5 cm in size with the use of laser lithotripsy constituted 17.31 ± 2.11 minutes being unreliably higher than in case of endoscopic treatment of “standard” calculi using ultrasound probe (р> 0.5). Duration of the surgery was the largest in patients of the group with complex calculi using laser lithotripsy, regardless of the size of stone up to 1.5 cm and constituted 27.84 ± 2.41 minutes (differences were significant in comparison with other groups, p< 0.01). Conclusions. Comparative analysis of the surgery course, namely contact ureteral lithotripsy using ultrasound lithotripters in patients with “standard” and complex ureteral calculi and laser ureteral lithotripsy in patients with the calculi up to 1 cm in size and over 1.5 cm in size showed undeniable advantages of the latter in the treatment of complex ureteral calculi.?