Efficacy of Pneumatic Lithoclast in the Management of Ureteric Calculi

Abstract

Background: To assess the efficacy and safety of pneumatic lithoclast in the management of
ureteric calculi.
Methods: One hundred and four patients with ureteric calculi were treated by pneumatic
lithoclast at department of Urology Services Hospital Lahore from Jan 2005 to December 2006.
Record of the patients was analyzed retrospectively. Patients above 15 years from both sexes
with calculi measuring more than 0.5cm (in the largest diameter) were treated in upper, middle,
and lower ureter. Calculi were approached with 8fr ureteroscope and fragmented with Swiss
lithoclast. After the completion of the procedure, ureter was stented. Patients were followed up till
they became stone free. Following parameters were assessed: stone size, site, laterallity, degree
of fragmentation, success rate, stone migration, type and duration of stenting, post operative
hospital stay and complications. Requirement of another procedure or inability to enter the ureter
were considered failure.
Results: One hundred and six ureteric calculi were treated in 104 patients. Amongst those, 22
stones were in upper ureter, 16 in the middle ureter and 68 stones were in lower ureter. Mean
stone size was 11.2mm (largest diameter). Overall success rate was 89.2%. Whereas success
rate in upper, middle and lower ureter was 63.6 %, 87.5% and 95.6% respectively. Mean
postoperative hospital stay was 26.5 hours. There were no major complications.
Conclusions: Pneumatic lithoclast with URS is effective and safe in the management of the
ureteric calculi. However, success is limited in the upper ureter