OUTCOMES OF URETERORENOSCOPY WITH PNEUMATIC LITHOCLAST FOR URETERIC STONE MANAGEMENT AT A REGIONAL CENTER: A RETROSPECTIVE STUDY

I SHAHZAD; M MANZOOR; KH AWAN; MA YOUSUF; GM PATHAN; S KUMAR

doi:10.54112/bcsrj.v2024i1.878

Authors

I SHAHZAD Department of Urology, Liaquat National Hospital, Karachi, Pakistan
M MANZOOR Department of General Surgery, Kutyana Memon Hospital, Karachi, Pakistan
KH AWAN Department of Urology, Bantva Memon Hospital, Karachi, Pakistan
MA YOUSUF Usman Memorial Hospital, Hussainabad, Pakistan
GM PATHAN Department of Urology, Liaquat National Hospital, Karachi, Pakistan
S KUMAR Department of Urology, Ahalia Hospital Musafah Abu Dhabi, UAE

DOI:

https://doi.org/10.54112/bcsrj.v2024i1.878

Keywords:

Intra-corporeal lithotripsy, Pneumatic lithoclast, Stone migration, Ureteric stones, Ureterorenoscopy, Urology, Stone-free rate

Abstract

The management of ureteric stones has significantly evolved with the advancement of minimally invasive techniques. Ureterorenoscopy (URS) with pneumatic lithoclast has become favored due to its efficacy and safety, providing high success rates across various stone locations. Objective: To share our experiences and outcomes of treating ureteric stones using ureterorenoscopy and pneumatic lithoclast at our regional center. Methods: From 2014 to 2022, 220 patients with ureteral calculi at our regional center underwent 221 URS procedures using a pneumatic lithoclast. Preoperative evaluation included plain radiography, ultrasound scan, intravenous urography, and CT KUB. Postoperative assessments with plain film radiography and, if necessary, ultrasound or CT KUB were conducted immediately or a few days after the procedure. Results: The overall stone-free rate achieved was 95.4%. Specific success rates based on stone location were 88.4% for upper, 97% for middle, and 100% for lower ureteral stones. The primary cause of treatment failure, occurring in 4.5% of cases, was stone migration. Conclusion: Ureteroscopic intra-corporeal lithotripsy is a reliable and safe treatment modality for ureteric stones of various sizes and locations, demonstrating high efficacy when performed by experienced practitioners.

Downloads

Download data is not yet available.

References

Nour HH, Kamel AI, Elmansy H, Badawy MH, Shabana W, Abdelwahab A, et al. Pneumatic vs laser lithotripsy for mid-ureteric stones: Clinical and cost effectiveness results of a prospective trial in a developing country. Arab Journal of Urology. 2020;18(3):181-6.

Niazi AB, Asif M, Ahmed N. Comparison of utility and efficacy of Intracorporeal pneumatic lithoclast in the treatment of distal ureteric calculi versus open ureterolithotomy. Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University. 2020;16(1):26-31.

Hamouche F, Charondo L, Stoller M. Ureteral Stones. The Ureter: A Comprehensive Review: Springer; 2024. p. 439-63.

Pricop C, Ivanuta M, Radavoi GD, Toma C-V, Cumpanaş A, Jinga V, et al. Determining whether previous SWL for ureteric stones influences the results of ureteroscopy as the second‑line treatment: A clinical study. Experimental and Therapeutic Medicine. 2022;23(1):1-7.

Ayub MA, Akhlaque M, Shahzad I. Efficacy of Pneumatic Lithoclast in the Management of Different Metabolic Types of Stones in Lower one third of Ureter. Age (years). 2020;42:8.08.

Sirirak N, Sangkum P, Phengsalae Y, Kongchareonsombat W, Leenanupunth C, Ratanapornsompong W, et al. External validation of the STONE score in predicting stone-free status after rigid ureteroscopic lithotripsy. Research and Reports in Urology. 2021:147-54.

Sajid MT, Ameen M, Murtaza B, Alvi MS, Khan Z, Kiani F. Comparison of mean operative time in patients undergoing Ho: YAG laser lithotripsy and pneumatic lithotripsy in ureterorenoscopy for ureteric calculus. Pakistan Journal of Medical Sciences. 2021;37(2):415.

Akpayak IC, Agbo CA, Nabasu LE. Retrograde ureteroscopy in the management of distal ureteric stones: A retrospective analysis of outcome and complications. Annals of African Medicine. 2020;19(4):258-62.

Nerli RB, Sharma M, Gupta P, Adhikari P, Bidi S, Ghagane SC. Therapeutic ureteroscopy for urolithiasis in children younger than 60 months of age. Pediatric Surgery International. 2021;37:145-50.

Keller EX, De Coninck V, Traxer O, Shvero A, Kleinmann N, Hubosky SG, et al. Stones. Advanced Ureteroscopy: A Practitioner's Guide to Treating Difficult Problems: Springer; 2021. p. 105-54.

Kamadjou C, Eyongeta DE, Moby EH, Kuitche J, Angwafor F. Intraluminal Lithotripsy with Rigid Ureteroscopy for Proximal and Distal Ureteral Stones: Results of a Single Center in Cameroon. Open Journal of Urology. 2021;11(12):486-95.

Waseda Y, Takazawa R, Kobayashi M, Yoshida S, Uchida Y, Kohno Y, et al. Successful outcomes of endoscopic lithotripsy in completely bedridden patients with symptomatic urinary calculi. Scientific Reports. 2020;10(1):8839.

AKBAR SMA, AKHLAQUE M, SHAHZAD I, IMTIAZ S, KHAN S. To Compare the Outcome of Ureterorenoscopy (URS)/Lithoclast with (PCN) Percutaneous Nephrostomy and Ureterorenoscopy (URS)/Lithoclast alone in obstructed kidney due to ureteric calculus.

Orakzai AN, Wazir BG, Muhammad N, editors. Comparative Efficacy and Safety of Hand-Held and Conventional Intra-Corporeal Pneumatic Lithotripsy in the Treatment of Ureteric Stones. Medical Forum Monthly; 2023.

Haider A, Memon WA, Yaqoob U, Zubair R, Channa MA, Mirza MR, et al. Our Experience of Semi-rigid Ureteroscopy with Pneumatic LithoClast for Impacted Upper Ureteric Calculi. 2023.

Asad S, Gul B, Jalal-Ud-Din M, Khan SA, Bashir R, Rafaqat H. Frequency Of Stone Clearance After Transurethral Fragmentation Of Large Urinary Bladder Calculi Using Pneumatic Swiss Lithoclast. Journal of Ayub Medical College Abbottabad-Pakistan. 2023;35(1).

Umer M, Ayub A, Jumadin A. Efficacy of Pneumatic Lithoclast in Management of Different Metabolic Stones in Lower Ureter. Pakistan Journal of Medical & Health Sciences. 2022;16(08):99-.

Shalaby E. Assess the safety and effectiveness of a novel approach during transurethral pneumatic cystolithotripsy in large urinary bladder stone: quasi-clinical trial. Urolithiasis. 2022;50(2):189-97.

Shah RS, Shrestha N. Efficacy of Laser Vs Pneumatic Lithotripsy for Mid and Distal Ureteric Stone: A Comparative Study. Journal of Nepalgunj Medical College. 2022;20(1):16-9.

Morsi GA, Mahmoud AR, Deif HA, Mohammed MMO. Randomized Trial of Stone Fragment Active Retrieval Versus Spontaneous Passage after Pneumatic Lithotripsy of Ureteral Stones. The Egyptian Journal of Hospital Medicine. 2022;88(1):3999-4004.

Ahmad N, Khan K, Amjad S, Rasheed A, Iftikhar U, editors. Extracorporeal Shock Wave Lithotripsy versus Ureteroscopy Lithoclast in Management of Upper Ureteric Stones. Medical Forum Monthly; 2022.

Tahir M, Aeymon HM, editors. Comparison of Treatment Efficacy of Extracorporeal Shock Wave Lithotripsy and Pneumatic Ureteroscopic Lithotripsy for Lower Ureteric Stones. Med Forum; 2021.

Petca RC, Salaheddin Y, Mareș C, Popescu RI, Petca A, Diaconescu D, et al. Pneumatic Lithotripsy vs. Laser Lithotripsy in the Management of Proximal Ureteral Stones. Romanian Journal of Urology. 2021;20(3).

Galeti EH, Shahab S, Bharali MD. Comparison of pneumatic lithotripsy versus laser lithotripsy for upper ureteral calculi. International Surgery Journal. 2021;8(9):2644-9.

Bharali MD, Galeti EH, Shahab S. Semi-rigid Ureteroscopy and Pneumatic Lithotripsy for upper ureteric stones. International Archives of Integrated Medicine. 2021;8(6).