Comparative evaluation of intracorporeal lithotripsy techniques during ureteroscopy: a clinical experience


  • Pankaj Trivedi Department of Urology, Geetanjali Medical College and Hospital, Udaipur, Rajasthan



Ureteric stone, Pneumatic lithotripsy, Ho, YAG laser lithotripsy


Background: The objective of the study was to compare pneumatic lithotripsy and laser lithotripsy techniques for safety, efficacy, and complications in the management of ureteric stone.

Methods: Patients underwent ureteroscopy for ureteral stones in a tertiary care teaching hospital were divided into 2 groups of 50 each. Group 1 patients underwent pneumatic lithotripsy and group 2 underwent holmium:yttrium-aluminium-garnet (Ho: YAG) laser lithotripsy. Both the groups were compared regarding demographic characteristics, stone dimensions, number of stones, operative time, stone migration rate, application of post-operative double J (DJ) stent, complications, and stone free rate.

Results: Mean age of the patients in the group 1, and group 2 were 45.74±18.49, and 44.5±14.33 years, respectively (p=0.709). There was no significant difference in male to female ratio in both groups. Total operative times were found 29.12±10.83 min, and 28.44±7.49 min in the group 1 and group 2, respectively which was statistically non-significant (p=0.716). The stone free rate was 100% and 98% in group 1 and 2 respectively (p=0.130). Stone migration was also found in 5 (10%) patients in the group 1 and 1 (2%) in group 2 which was found statistically significant (p=0.037). Mucosal damage was found 3 (6%) in laser group as compared to 1 (2%) in pneumatic group. No significant difference between complications was seen in both the groups.

Conclusions: This study concluded that pneumatic lithotripsy and laser lithotripsy have similar efficacy in terms of operative time, success rate and hospital stay time. However, stone migration rate was significantly more in pneumatic lithotripsy.

Author Biography

Pankaj Trivedi, Department of Urology, Geetanjali Medical College and Hospital, Udaipur, Rajasthan

Assistant Professor, Department of Urology


Ordon M, Andonian S, Blew B, Schuler T, Chew B, Pace KT. CUA Guideline: Management of ureteral calculi. Can Urol Assoc J. 2015;9(11-12):837-51.

Wang Y, Zhong B, Yang X, Wang G, Hou P, Meng J. Comparison of the efficacy and safety of URSL, RPLU, and MPCNL for treatment of large upper impacted ureteral stones: a randomized controlled trial. BMC Urol. 2017;17:50.

Sun Y, Wang L, Liao G, Xu C, Gao X, Yang Q, et al. Pneumatic lithotripsy versus laser lithotripsy in the endoscopic treatment of ureteral calculi. J Endourol. 2001;15:587-90.

Kispe HH, Klein R, Heicappell R, Miller K. Pneumatic lithotripsy applied through deflected working channel of miniureteroscope: Results in 143 patients. J Endourol. 1998;12:513-5.

Rabani SM, Rabani S, Rashidi N. Laser versus pneumatic lithotripsy with semi-rigid ureteroscope; a comparative randomized study. J Lasers Med Sci. 2019;10(3):185-8.

Nour HH, Kamel AI, Elmansy H, Badawy MH, Shabana W, Abdelwahab A, et al. Pneumatic vs laser lithotripsy for mid-ureteric stones: Clinical and cost effectiveness results of a prospective trial in a developing country. Arab J Urol. 2020;18(3):181-6.

Kassem A, Elfayoumy H, Elsaied W, Elgammal M, Bedair A. Laser and pneumatic lithotripsy in the endoscopic management of large ureteric stones: a comparative study. Urol Int. 2012;88:311-5.

Salvado JA, Mandujano R, Saez I, Saavedra A, Dell’oro A, Dominguez J, et al. Ureteroscopic lithotripsy for distal ureteral calculi: comparative evaluation of three different lithotriptors. J Endourol. 2012;26:343-6.

Akdeniz E, Irkılata L, Demirel HC, Saylık A, Bolat MS, Sahinkaya N, et al. A comparison of efficacies of holmium YAG laser, and pneumatic lithotripsy in the endoscopic treatment of ureteral stones. Turkish J Urol. 2014;40(3):138-43.

Strope SA, Wolf JS Jr, Hollenbeck BK. Changes in gender distribution of urinary stone disease. Urology. 2010;75(3):543-6.

Khoder WY, Bader M, Sroka R, Stief C, Waidelich R. Efficacy and safety of Ho: YAG laser lithotripsy for ureteroscopic removal of proximal and distal ureteral calculi. BMC Urol. 2014;14:62.

Abedi AR, Razzaghi MR, Allameh F, Aliakbari F, FallahKarkan M, Ranjbar A. Pneumatic Lithotripsy Versus Laser Lithotripsy for Ureteral Stones. J Lasers Med Sci. 2018;9(4):233-6.

Degirmenci T, Gunlusoy B, Kozacioglu Z, Arslan M, Koras O, Arslan B, et al. Comparison of Ho:YAG laser and pneumatic lithotripsy in the treatment of impacted ureteral stones: an analysis of risk factors. Kaohsiung J Med Sci. 2014;30(3):153-8.

Muslumanoglu AY, Fuglsig S, Frattini A, Labate G, Nadler RB, Martov A, et al. Risks and Benefits of Postoperative Double-J Stent Placement After Ureteroscopy: Results from the Clinical Research Office of Endourological Society Ureteroscopy Global Study. J Endourol. 2017;31(5):446-51.

Ahallal Y, Khallouk A, El Fassi MJ, Farih MH. Risk factor analysis and management of ureteral double-j stent complications. Rev Urol. 2010;12(2-3):147-51.

Isen K, Hatipoglu NK, Dedeoglu S, Atilgan I, Caca FN, Hatipoglu N. Experience with the diagnosis and management of symptomatic ureteric stones during pregnancy. Urology. 2012;79:508-12.

Sen H, Bayrak O, Erturhan S, Urgun G, Kul S, ERbagci A, et al. Comparing of different methods for prevention stone migration during ureteroscopic lithotripsy. Urol Int. 2014;92:334-8.

Li L, Pan Y, Weng Z, Bao W, Yu Z, Wang F. A prospective randomized trial comparing pneumatic lithotripsy and holmium laser for management of middle and distal ureteral calculi. J Endourol. 2015;29:883-7.

Bapat SS, Pai KV, Purnapatre SS, Yadav PB, Padye AS. Comparison of holmium laser and pneumatic lithotripsy in managing upper-ureteral stones. J Endourol. 2007;21:1425-8.

Maghsoudi R, Amjadi M, Norizadeh D, Hassanzadeh H. Treatment of ureteral stones: A prospective randomized controlled trial on comparison of Ho:YAG laser and pneumatic lithotripsy. Indian J Urol. 2008;24:352-4.

Bora I, Volkan S, Oguzcan E, Huseyin AY, Sakir O, Onder C, et al. Comparison of efficacy and complications of holmium laser and pneumatic lithotripters used in the ureterorenoscopic treatment of proximal ureter stones, a multi-center study of society of urological surgery aegean study group. J Urol Surg. 2018;5:158-63.

Chen S, Zhou L, Wei T, Luo D, Jin T, Li H, et al. Comparison of Holmium: YAG Laser and Pneumatic Lithotripsy in the Treatment of Ureteral Stones: An Update Meta-Analysis. Urol Int. 2017;98(2):125-33.






Original Research Articles