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Comparison of the effectiveness of crushing concrements in the urinary tract with the use of holmium laser and sonotrode.

Jakóbczyk B, Wrona M, Lipiński M, Różański W - Cent European J Urol (2011)

Bottom Line: The total effectiveness of the procedure reached 92% (90 out of 98 procedures).In group II, the total effectiveness of the procedure reached 79% (52 out of 66 procedures).The results prove that laser lithotripsy is a method of high effectiveness with a low risk of complication.

View Article: PubMed Central - PubMed

Affiliation: 2 Clinic of Urology, Department of Urology, Medical University, Łódź, Poland.

ABSTRACT

Introduction: Holmium lasers and ultrasound probes are widely used in urinary stone lithotripsy. The authors present a comparison of both methods in urinary stones lithotripsy.

Materials and methods: We analyzed 164-patients who underwent endoscopic lithotripsy. Ninety-eight of them (group I) were treated with the holmium laser Omni-Pulse Max 80 and were compared to the other 66-patients (group II) who were operated on with an ultrasound probe (sonotrode). Prior to the procedures, all patients were exposed to urological ultrasound and radiological imaging in order to localize the stone. The state where the stones were invisible in the radiological and renal ultrasound imaging that was performed after the operation was considered to be effective. Patients were operated under intravenous general or subepidural anesthesia.

Results: The effectiveness of laser lithotripsy in the bladder amounted to 100% (25 of 25 patients). In the case of stones localized in the ureter it reached 89%. The total effectiveness of the procedure reached 92% (90 out of 98 procedures). In group II, the total effectiveness of the procedure reached 79% (52 out of 66 procedures). In group I, two cases the inflammatory changes of the ureter made the endoscopy impossible. These two patients were operated with open surgery. In one case, the laser lithotripsy was complicated with a perforation of the ureter.

Conclusion: The results prove that laser lithotripsy is a method of high effectiveness with a low risk of complication. It might surpass sonotrode and become its alternative. Both methods have both advantages and disadvantages.

No MeSH data available.


Related in: MedlinePlus

Concrement location.
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Figure 0001: Concrement location.

Mentions: The evaluated group consisted of 168-patients who underwent the procedure of endoscopic crushing of concrements in the urinary tract. The procedures were performed in the 2nd Clinic of Urology in Łódź within the period from September 2008 to March 2010. All 66 subsequent procedures, starting from September 2008 up to the moment of buying holmium laser Omni Pulse Max 80 W, were performed with the use of sonotrode (group II). Starting from this moment, 98 subsequent patients were operated with the use of holmium laser (group I). Group I consisted of 41 (42%) women and 57 (58%) men (Tab. 1). The average age of patients is 39-years (18-63). In 25 (26%) cases the stone was located in the bladder and in 73 (74%) cases – the ureter (in 32 cases (32%) – its lower part; in 15 cases (15%) – its central part; and in 26 cases (26%) – its upper part). The size of the concrements ranged from 10- to 21-mm in the case of the bladder and from 5- to 17-mm in the ureter. The group of patients operated on with the sonotrode (group II) consisted of 32 (49%) women and 34 (51%) men. The average age of patients was 45-years (range: 19-67). In 14 cases (21%) the stones were crushed in the bladder and in 52 cases (79%) in the ureter (in 36 cases (55%) - its lower part; in 8 cases (12%) – its central part; and in 8 cases (12%) – its upper part) (Fig. 1). The size of the concrements was between 7- and 30-mm. The statistic analysis did not show a statistically significant difference between the evaluated groups in terms of the size of the crushed concrements (arithmetic average: 9.44-mm in group II and 9.76-mm in group I) (Table 1).


Comparison of the effectiveness of crushing concrements in the urinary tract with the use of holmium laser and sonotrode.

Jakóbczyk B, Wrona M, Lipiński M, Różański W - Cent European J Urol (2011)

Concrement location.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3921703&req=5

Figure 0001: Concrement location.
Mentions: The evaluated group consisted of 168-patients who underwent the procedure of endoscopic crushing of concrements in the urinary tract. The procedures were performed in the 2nd Clinic of Urology in Łódź within the period from September 2008 to March 2010. All 66 subsequent procedures, starting from September 2008 up to the moment of buying holmium laser Omni Pulse Max 80 W, were performed with the use of sonotrode (group II). Starting from this moment, 98 subsequent patients were operated with the use of holmium laser (group I). Group I consisted of 41 (42%) women and 57 (58%) men (Tab. 1). The average age of patients is 39-years (18-63). In 25 (26%) cases the stone was located in the bladder and in 73 (74%) cases – the ureter (in 32 cases (32%) – its lower part; in 15 cases (15%) – its central part; and in 26 cases (26%) – its upper part). The size of the concrements ranged from 10- to 21-mm in the case of the bladder and from 5- to 17-mm in the ureter. The group of patients operated on with the sonotrode (group II) consisted of 32 (49%) women and 34 (51%) men. The average age of patients was 45-years (range: 19-67). In 14 cases (21%) the stones were crushed in the bladder and in 52 cases (79%) in the ureter (in 36 cases (55%) - its lower part; in 8 cases (12%) – its central part; and in 8 cases (12%) – its upper part) (Fig. 1). The size of the concrements was between 7- and 30-mm. The statistic analysis did not show a statistically significant difference between the evaluated groups in terms of the size of the crushed concrements (arithmetic average: 9.44-mm in group II and 9.76-mm in group I) (Table 1).

Bottom Line: The total effectiveness of the procedure reached 92% (90 out of 98 procedures).In group II, the total effectiveness of the procedure reached 79% (52 out of 66 procedures).The results prove that laser lithotripsy is a method of high effectiveness with a low risk of complication.

View Article: PubMed Central - PubMed

Affiliation: 2 Clinic of Urology, Department of Urology, Medical University, Łódź, Poland.

ABSTRACT

Introduction: Holmium lasers and ultrasound probes are widely used in urinary stone lithotripsy. The authors present a comparison of both methods in urinary stones lithotripsy.

Materials and methods: We analyzed 164-patients who underwent endoscopic lithotripsy. Ninety-eight of them (group I) were treated with the holmium laser Omni-Pulse Max 80 and were compared to the other 66-patients (group II) who were operated on with an ultrasound probe (sonotrode). Prior to the procedures, all patients were exposed to urological ultrasound and radiological imaging in order to localize the stone. The state where the stones were invisible in the radiological and renal ultrasound imaging that was performed after the operation was considered to be effective. Patients were operated under intravenous general or subepidural anesthesia.

Results: The effectiveness of laser lithotripsy in the bladder amounted to 100% (25 of 25 patients). In the case of stones localized in the ureter it reached 89%. The total effectiveness of the procedure reached 92% (90 out of 98 procedures). In group II, the total effectiveness of the procedure reached 79% (52 out of 66 procedures). In group I, two cases the inflammatory changes of the ureter made the endoscopy impossible. These two patients were operated with open surgery. In one case, the laser lithotripsy was complicated with a perforation of the ureter.

Conclusion: The results prove that laser lithotripsy is a method of high effectiveness with a low risk of complication. It might surpass sonotrode and become its alternative. Both methods have both advantages and disadvantages.

No MeSH data available.


Related in: MedlinePlus