Shams-ul Islam, Fawad Nasrullah, Waqas Mizra, Ahad Pervaiz, Syed M Hassan Akhtar, Saqib Munir Suleri.
Comparison of Proximal Ureteric Stones (10-20mm) Clearance between Holmium: Yag Laser and Pneumatic Lithotripsy.
Pak J Med Health Sci Jan ;13(2):353-6.

Background: Pakistan li es in the Afro-Asia stone belt with significant urinary disease burden on healthcare facilities. The implication of laser technology in the development of lithotripter fibers has revolutionized intra- corporeal lithotripsy. Aim: To compare proximal ureteric stone clearance between holmium: YAG Laser and pneumatic lithotripsy Study design: Randomized controlled trial. Setting : Urology Department , KEMU/Mayo Hospital, Lahore. Duration of study : 06 months after the approval of synopsis ( 27/05/2017- 26/11/2017) Methodology : 92 patients with proximal ureteric stone of 10-20 mm size seen on CT scan were included. Stone clearance was accessed on follow-up after 4 weeks of laser treatment , with radiological investigations Results: In our study group ratio of male gender with female gender was 2.2:1. Stone size varied from 10 to 20 mm with a mean of 13.32+/-3.03mm. 66.3% patients had stone size 10-14 mm while 33.7% patients with ≥15mm; in right ureter (46.7%) and left ureter (53.3%). No statistically significant difference in terms of mean age (p=0.884) , mean stone size (p=0.707), age (p=0.788), gender (p=0.822), stone size (p=0.825) and anatomical side (p=0.834) group was seen. The frequency of stone clearance was significantly higher in patients treated with holmium YAG laser versus pneumatic lithotripsy (93.5% vs. 76.1%; p=0.020) . Conclusion : Stone clearance is better with holmium YAG laser lithotripsy as compared to pneumatic lithotripsy in proximal ureteric stone patients, this advocate preferred use of holmium YAG laser in future urologic practice.

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