Comparison of Outcome of Laser and Pneumatic Ureteroscopic Lithotripsy (URS) for Ureteric Stones
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Abstract
Objective:
To evaluate and compare the stone-free rate and the extent of stone migration between laser and pneumatic ureteroscopic lithotripsy (URS) in patients presenting with ureteric calculi.
Methodology:
A quasi-experimental study was carried out in the Department of Urology over a six-month period, from June to December 2022. A total of 158 patients, aged between 18 and 60 years, with ureteric stones measuring 7–20 mm in diameter, were included. The participants were allocated into two equal groups: Group A, treated with pneumatic URS (n = 79), and Group B, treated with laser URS (n = 79). All underwent standard preoperative evaluation followed by ureteroscopy using either pneumatic or laser lithotripsy. Stone-free rate and stone-migration were assessed outcomes. Data were analyzed using SPSS version 20.0. The Chi-square test was applied for categorical variables and Student’s t-test for continuous variables, with p < 0.05 considered statistically significant.
Results:
In Group A (pneumatic URS), the mean age was 41 ± 12.77 years; 50 (63%) were male and 29 (37%) were female. In Group B (laser URS), the mean age was 41 ± 10.12 years; 51 (65%) were male and 28 (35%) were female. No significant difference between groups regarding age or gender (p > 0.05). Stone-free rate was significantly higher in Group B (laser URS) 70 (89%) versus 55 (70%) in Group A (p = 0.0033, Chi-square test). stone-migration occurred in 61 (77%) of Group B and 67 (85%) of Group A, with no significant difference (p = 0.2235). Perforation observed more in Group A (16%) than Group B (5%) (p = 0.0208, Chi-square test), while other complications showed no statistically significant difference (p > 0.05).
Conclusion:
Laser lithotripsy demonstrated significantly higher stone-free rates and fewer complications, particularly a lower rate of ureteric perforation, compared to pneumatic URS. Although stone-migration was lower in the laser group, the difference was not statistically significant. Overall, laser URS proved to be a more effective and safer option for the management of ureteric stones.
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