Ureteroscopic Lithotripsy Using Mini-Endoscope and Swiss Lithoclast: Experience in 147 Cases

Abstract

To evaluate the efficacy of a semirigid mini-endoscope and the Swiss Lithoclast compared with a conventional rigid endoscope and ultrasound, the results of transurethral ureteroscopic lithotripsy in 147 patients over a period of 30 months were analyzed according to the type of ureteroscope (rigid v semirigid) and energy (ultrasound v Lithoclast) used. In the initial 25 cases (Group I), a conventional rigid ureteroscope and ultrasound were used. The latter 122 patients (Group II) were subjected to ureteroscopic lithotripsy using a miniscope and the Lithoclast. The results were superior in Group II with respect to the overall success rate (p = 1.6 x 10[-2]), first-attempt success rate (p = 2.9 x 10[-4]), and the need for ureteral dilation (P = 1.0 x 10[-6]) compared with Group I. There were no major complications. Overall, minor complications (hematuria and urinary tract infection) were observed in 25% of the cases. Further, the results of ureteroscopic lithotripsy in Group II were comparable to those of SWL in situ for upper ureteral calculi and better than for those located in the iliac and lower ureter as reported previously. Our results demonstrate that the Swiss Lithoclast provides effective fragmentation of even hard and smooth stones without increasing the complication rate. This lithotripter is reliable, safe, and simple to operate. In addition, the cost of maintenance is almost nil.

Treatment of Ureteral Stones: Comparison of Extracorporeal Shock Wave Lithotripsy and Endourologic Alternatives

“…Although both fragmentation and complication rates were not more significant than USL (p = 0.32, p = 0.13), PL had a slightly better fragmentation rate and was more cost effective due to the lower maintenance costs than for other lithotriptors. The success rate of PL has also been shown to reach 100% with minimal morbidity in some reports [23]. Our overall fragmentation rates are 97.1, 89.4 and 93.3%, respectively, for PL, USL and EHL.…”

Pneumatic lithotripsy for large ureteral stones: is it the first line treatment?

“…Among these treatment options we use PL successfully since 1995 for ureteral stone treatment. According to the literature, the success rate of PL appears to be higher than 90% [2,3,14,17]. In this study, although we only included patients who had stones larger than 1 cm (mean diameter 12.87 cm), we achieved an overall success rate of 92.3%, which is similar to the literature regarding the general results of PL.…”

Iatrogenic Ureteric Injuries: Incidence, Aetiological Factors and the Effect of Early Management on Subsequent Outcome

“…The use of small calibre ureteroscopes are also known to reduce the incidence of iatrogenic ureteric injuries [15]. Treatment options for ureteric injuries instituted in this series included PCN insertion with expectation of spontaneous resolution, ureteric catheter placement or ''J'' stent insertions in cases of ureteric mucosa injury, ureteric perforations and false passages.…”