Abdul Manan, Muhammad Shahzad Anwar, Asad Ali Shah, Arshad Mahmood, Riaz A Tasneem.
Efficacy of pneumatic Lithoclast in the management of ureteric calculi.
Esculapio J Services Inst Med Sci Jan ;2(2):29-32.

Background: To assess the efficacy and safety of pneumatic lithoclast in the management of ureteric calculi. Methods: One hundred and four patients with ureteric calculi were treated by pneumatic lithoclast at department of Urology Services Hospital Lahore from Jan 2005 to December 2006. Record of the patients was analyzed retrospectively. Patients above 15 years from both sexes with calculi measuring more than 0.5cm (in the largest diameter) were treated in upper, middle, and lower ureter. Calculi were approached with 8fr ureteroscope and fragmented with Swiss lithoclast. After the completion of the procedure, ureter was stented. Patients were followed up till they became stone free. Following parameters were assessed: stone size, site, laterallity, degree of fragmentation, success rate, stone migration, type and duration of stenting, post operative hospital stay and complications. Requirement of another procedure or inability to enter the ureter were considered failure. Results: One hundred and six ureteric calculi were treated in 104 patients. Amongst those, 22 stones were in upper ureter, 16 in the middle ureter and 68 stones were in lower ureter. Mean stone size was 11.2mm (largest diameter). Overall success rate was 89.2%. Whereas success rate in upper, middle and lower ureter was 63.6 %, 87.5% and 95.6% respectively. Mean postoperative hospital stay was 26.5 hours. There were no major complications. Conclusions: Pneumatic lithoclast with URS is effective and safe in the management of the ureteric calculi. However, success is limited in the upper ureter. Ureteric stones, Ureterorenoscopy, Pneumatic Lithoclast.

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