AB093. Treatment of upper ureteral calculi with trans-ureteroscopic holmium laser lithotripsy

Objective: To study the clinical effects of using ureteroscopic holmium laser lithotripsy to treat patients with upper urinary tract calculi.

Methods: We analysis the clinical materials of 260 cases patients in our hospital using ureteroscopic holmium laser lithotripsy to treat patients with upper ureteral stones in 2014.

Results: The overall successful rate of fragmentation for all ureteral stones in a single procedure achieved 93.1% (242/260). Ten cases were fragmented successfully by ESWL, four cases were fragmented successfully by flexible ureteroscope, two cases were fragmented successfully by mPCNL, two cases were fragmented successfully by laparoscopic. Operation time ranged 36 min (mean 36.±47.9 min), and duration of hospitalization after operation was 3-7 d, with an average 4.5 d. There were 15 patients with urinary tract infection and suffered fever. One patient with ureteral perforation, and no one with ureteral avulsion or long term complications such as ureteral stricture. The stone-free rate was 98.3% (238/242) in a month postoperation.

Conclusions: Trauma patients are small, quick recovery and fewer complications. It is an ideal methods treatment of urinary calculi, especially in some complex upper urinary tract stones, such as patients failed from ESWL or with stone wrapped by hyperplasia tissues. Correct and skilled ureteroscopic holmium laser management may decrease the complication. Breaking the stones gradually, and using small power and slow lavage can prevent stones from translocating efficiently. To treat stones which combined with polyps or wrapped by hyperplasia tissues, it is not necessary to clear the polyps or hyperplasia tissues absolutely, but the stones must be removed absolutely.

Keywords: Upper ureteral calculi; ureteroscope; holmium laser