Holmium Laser Ureteroscopy in the Treatment of the Upper Urinary Tract Stones: Concerning 54 Cases in the Surgical Department of the Saint Camille Hospital of Ouagadougou (Burkina Faso)

Abstract

The treatment of urinary stones uses a varied therapeutic arsenal. Nowadays the mini-invasive techniques are the most used. We report our first experience on the results of flexible and semi-rigid ureteroscopy in the treatment of the upper urinary tract stones. Materials and Methods: A 20-month prospective study on flexible laser ureteroscopy was conducted at the Saint Camille Hospital of Ouagadougou. The inclusion criteria were for patients who had given informed consent and the presence of an unilateral obstructive upper urinary tract stone with an indication of surgical management. Results: 54 patients were treated with Holmium laser photo vaporization between January 2018 and August 2019. The average age of patients was 37.74 ± 17 years (11-83 years). The men were predominant at 55.56%, or a sex-ratio of 1.25. The average size of stones of 17.55 mm ± 4.16 mm (11 mm to 25 mm) with pyelic, ureteral and calyceal localization in respectively 42.6%, 33.3% and 24.1% of cases. The average duration of the interventions was 77.92 ± 43.57 minutes (11 to 180 minutes). We used drainage in 90.91% of the cases. The average duration of hospitalization was 1.2 ± 0.73 days with extremes ranging from one day to 6 days. The vaporization without residual fragment which is a success was 78.46%. Conclusion: Laser ureteroscopy is a newly used method at the Saint Camille hospital. The achievement of good results and its low morbidity encourage us to promote its extension and its use in sub-Saharan African hospitals.

<p>Surgical Management of Urolithiasis of the Upper Tract – Current Trend of Endourology in Africa</p>

“…The sizes of stones managed in the series ranged from 5-95 mm. 16,23,47,49 The rate of open surgery for upper tract urolithiasis was about 69.5% in the review with nephrolithotomy 20.8%, pyelolithotomy 37.9%, ureterolithotomy 29.9% and nephrectomy 7.9%. Authors from Senegal (Diallo et al; /Kane et al) 11,12 and Kenya (Ngugi et al; Wathigo et al) 19,20 reported a considerable use of endoscopic surgery for upper tract urolithiasis.…”

“…A recent study by Yaméogo et al in Ouagadougou Burkina Faso published the use of ureteroscopy and holmium laser lithotripsy for upper tract urinary stones. 47 A similar report from Kenya reviewing 67 patients with upper tract urolithiasis showed that 77.6% of cases were managed with laser lithotripsy. 20 Another retrospective study by Adusei et al in Ghana, evaluating 42 patients who underwent intracorporeal lithotripsy, revealed that the commonest procedure was ureteroscopy.…”