Comparison of Outcomes of Pneumatic Ballistic Lithotripsy, Holmium Laser Lithotripsy, and Combined Electromagnetic with Ultrasonic Lithotripsy during Percutaneous Nephrolithotomy


  • Mansoor Ejaz Department of Urology, Tabba Kidney Institute, Karachi Pakistan
  • Sherjeel Saulat Department of Urology, Tabba Kidney Institute, Karachi Pakistan
  • Syed Saeed Uddin Qadri Department of Urology, Tabba Kidney Institute, Karachi Pakistan
  • Awais Ayub Department of Urology, Tabba Kidney Institute, Karachi Pakistan



Complications, Hematuria, Laser lithotripsy, Pneumatic lithotripsy, Stone clearance, Trilogy lithotripsy, urolithiasis


Objective: To compare outcomes of combined electromagnetic with ultrasonic lithotripter, pneumatic ballistic lithotripter, and holmium laser lithotripter among patients at a Tertiary Care Hospital.

Study Design: Prospective comparartieve study.

Place and Duration of Study: Department of Urology at Tabba Kidney Institute, Karachi Pakistan, from May 2020 to Jun 2021.

Methodology: Ninety patients were divided into three groups of lithotripsy energies. Group-A (n=30) patients got pneumatic lithotripsy, Group-B (n=30) patients got laser lithotripsy, while Group-C (n=30) patients got trilogy lithotripsy technique. Outcomes such as post-operative pain, post-operative complications, and stone clearance were evaluated in all groups.

Results: The overall mean age of the patients was 50.23±9.24 years, ranging from 33-74 years. The majority of the participants were males (n=52,57.8%), and 38(35.6%) of the participants were females. The intra-operative time, severity of post-operative pain, fever and UTI were the same between the three groups. However, the proportion of hematuria (p=0.001) and stone clearance (p=0.025) significantly differed between the three groups.

Conclusion: Laser and pneumatic lithotripter were more effective in complete stone clearance than trilogy lithotripter. While laser lithotripter significantly decreases the occurrence of hematuria.


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Original Articles

How to Cite

Ejaz M, Saulat S, Qadri SSU, Ayub A. Comparison of Outcomes of Pneumatic Ballistic Lithotripsy, Holmium Laser Lithotripsy, and Combined Electromagnetic with Ultrasonic Lithotripsy during Percutaneous Nephrolithotomy. Pak Armed Forces Med J [Internet]. 2023 Dec. 30 [cited 2024 Jun. 15];73(6):1725-8. Available from: