Flexible Ureteroscopy With Holmium Laser Disintegration Versus Stented Extracorporeal Shock Wave Lithotripsy in the Management of Upper Ureteric Stone: Outcome and Complications

Abstract

his study was conducted upon 30 patients as a prospective randomized trail comparing flexible ureteroscopy and holmium laser lithotripsy and stented ESWL in the management of upper ureteric stone. PUT and pelviabdominal ultrasound were performed for all patients after 2 weeks and the stone free status was defined as the radiologic absence of stones or asymptomatic patients with stones <3mm after the ESWL sessions or flexible ureteroscopy. This study demonstrated the superiority of flexibe ureteroscopy and holmium laser lithotripsy over stented ESWL in the stone free rate and in the post operative complications in the management of large upper ureteric stones causing marked hydroureteronephrosis. Also this study proved the importance of DJ application prior to ESWL in stone clearance as it has improved the overall stone free rate and decreased the complications in patients with severe hydroureteronephrosis. To summarize the study, flexible ureteroscopy and holmium laser lithotripsy can be used as the first choice in patients with large upper ureteric stone without fearing the intra operative or post operative complications.