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Ureteroscopic management of ureteral calculi: electrohydraulic versus holmium:YAG lithotripsy.
J Urol. 1997 Oct; 158(4):1357-61.JU

Abstract

PURPOSE

This study compared electrohydraulic and holmium:YAG lithotripsy for ureteral calculi.

MATERIALS AND METHODS

Two cohorts of consecutive patients with ureteral calculi treated with ureteroscopic electrohydraulic or holmium:YAG lithotripsy were retrospectively compared. Electrohydraulic lithotripsy was done using a 1.9F fiber at energy settings between 50 and 100 v. Holmium:YAG lithotripsy was done using a 365 microm. fiber at energy settings of 0.6 to 1.5 J.

RESULTS

A total of 23 and 47 consecutive patients underwent electrohydraulic and holmium:YAG lithotripsy, respectively. For preoperative calculi less than 15 mm. mean stone size plus or minus standard deviation was 9 +/- 3 versus 9 +/- 3 mm. (p = 0.5), mean operative time was 72 +/- 21 versus 102 +/- 38 minutes (p = 0.004), stone-free rate at the end of ureteroscopy was 65 versus 97 (p < 0.01) and 3-month stone-free rate was 94 versus 97% (p = 0.4) for electrohydraulic versus holmium:YAG lithotripsy. For preoperative calculi 15 mm. or greater stone size was 19 +/- 5 versus 19 +/- 4 mm. (p = 0.9), operative time was 159 +/- 61 versus 108 +/- 27 minutes (p = 0.01), stone-free rate at the end of ureteroscopy was 33 versus 87% (p = 0.001) and 3-month stone-free rate was 67 versus 100% (p = 0.02). Complications were not significantly different in either comparison.

CONCLUSIONS

The overall likelihood that a patient would be rendered stone-free at ureteroscopy and 3 months after ureteroscopy favored holmium:YAG over electrohydraulic lithotripsy. For ureteral calculi less than 15 mm. electrohydraulic lithotripsy was more rapid than the holmium:YAG procedure but for ureteral calculi 15 mm. or greater the holmium:YAG technique was more rapid than electrohydraulic lithotripsy. The outcomes differences may have resulted from the different mechanisms of electrohydraulic and holmium:YAG lithotripsy.

Authors+Show Affiliations

Division of Urology, University of Texas Health Science Center, San Antonio, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

9302119

Citation

Teichman, J M., et al. "Ureteroscopic Management of Ureteral Calculi: Electrohydraulic Versus holmium:YAG Lithotripsy." The Journal of Urology, vol. 158, no. 4, 1997, pp. 1357-61.
Teichman JM, Rao RD, Rogenes VJ, et al. Ureteroscopic management of ureteral calculi: electrohydraulic versus holmium:YAG lithotripsy. J Urol. 1997;158(4):1357-61.
Teichman, J. M., Rao, R. D., Rogenes, V. J., & Harris, J. M. (1997). Ureteroscopic management of ureteral calculi: electrohydraulic versus holmium:YAG lithotripsy. The Journal of Urology, 158(4), 1357-61.
Teichman JM, et al. Ureteroscopic Management of Ureteral Calculi: Electrohydraulic Versus holmium:YAG Lithotripsy. J Urol. 1997;158(4):1357-61. PubMed PMID: 9302119.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Ureteroscopic management of ureteral calculi: electrohydraulic versus holmium:YAG lithotripsy. AU - Teichman,J M, AU - Rao,R D, AU - Rogenes,V J, AU - Harris,J M, PY - 1997/9/25/pubmed PY - 1997/9/25/medline PY - 1997/9/25/entrez SP - 1357 EP - 61 JF - The Journal of urology JO - J. Urol. VL - 158 IS - 4 N2 - PURPOSE: This study compared electrohydraulic and holmium:YAG lithotripsy for ureteral calculi. MATERIALS AND METHODS: Two cohorts of consecutive patients with ureteral calculi treated with ureteroscopic electrohydraulic or holmium:YAG lithotripsy were retrospectively compared. Electrohydraulic lithotripsy was done using a 1.9F fiber at energy settings between 50 and 100 v. Holmium:YAG lithotripsy was done using a 365 microm. fiber at energy settings of 0.6 to 1.5 J. RESULTS: A total of 23 and 47 consecutive patients underwent electrohydraulic and holmium:YAG lithotripsy, respectively. For preoperative calculi less than 15 mm. mean stone size plus or minus standard deviation was 9 +/- 3 versus 9 +/- 3 mm. (p = 0.5), mean operative time was 72 +/- 21 versus 102 +/- 38 minutes (p = 0.004), stone-free rate at the end of ureteroscopy was 65 versus 97 (p < 0.01) and 3-month stone-free rate was 94 versus 97% (p = 0.4) for electrohydraulic versus holmium:YAG lithotripsy. For preoperative calculi 15 mm. or greater stone size was 19 +/- 5 versus 19 +/- 4 mm. (p = 0.9), operative time was 159 +/- 61 versus 108 +/- 27 minutes (p = 0.01), stone-free rate at the end of ureteroscopy was 33 versus 87% (p = 0.001) and 3-month stone-free rate was 67 versus 100% (p = 0.02). Complications were not significantly different in either comparison. CONCLUSIONS: The overall likelihood that a patient would be rendered stone-free at ureteroscopy and 3 months after ureteroscopy favored holmium:YAG over electrohydraulic lithotripsy. For ureteral calculi less than 15 mm. electrohydraulic lithotripsy was more rapid than the holmium:YAG procedure but for ureteral calculi 15 mm. or greater the holmium:YAG technique was more rapid than electrohydraulic lithotripsy. The outcomes differences may have resulted from the different mechanisms of electrohydraulic and holmium:YAG lithotripsy. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/9302119/Ureteroscopic_management_of_ureteral_calculi:_electrohydraulic_versus_holmium:YAG_lithotripsy_ L2 - https://www.jurology.com/doi/full/10.1016/s0022-5347(01)64214-9?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -