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

Authors

  • 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

DOI:

https://doi.org/10.51253/pafmj.v73i6.8856

Keywords:

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

Abstract

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.

Downloads

Download data is not yet available.

References

Bouatia M, Benramdane L, Idrissi MOB. An epidemiological

study on the composition of urinary stones in Morocco in

relation to age and sex. Afr J Urol 2015; 21(3): 194-197.https://doi.org/10.1016/j.afju.2015.02.006.

Daudon M, Traxer O, Lechevallier E. Épidémiologie des lithiases

urinaires. Prog Urol 2008; 18(12): 802-814.https://doi.org/10.1016/j.purol.2008.09.029.

Fernström I, Johansson B. Percutaneous pyelolithotomy. A new

extraction technique. Scand J Urol Nephrol 1976; 10(3): 257-259.

https://doi.org/10.1080/21681805.1976.11882084.

Rajeev T, Pratihar SK, Sarma D. A Comparative Study between

Holmium Laser, Pneumatic Lithotripsy and Shock Pulse in

Terms of Efficacy and Safety in Percutaneous Nephrolithotomy

(PCNL): A Prospective Randomised Study. J Endolumin

Endourol 2020; 3(1): e1-e8.https://doi.org/10.22374/jeleu.v3i1.75.

Karakan T, Diri A, Hascicek AM. Comparison of ultrasonic and

pneumatic intracorporeal lithotripsy techniques duringpercutaneous nephrolithotomy. Sci World J 2013; 2013: 604361.https://doi.org/10.1155%2F2013%2F604361.

Cho CO, Yu JH, Sung LH. Comparison of percutaneous

nephrolithotomy using pneumatic lithotripsy (lithoclast®) alone

or in combination with ultrasonic lithotripsy. Korean J Urol 2010;

(11): 783-787. https://doi.org/10.4111/kju.2010.51.11.783.

Lin L, Zhou L, Xiao K. Does combined lithotripter show superior

stone-success rate than ultrasonic or pneumatic device alone

during percutaneous nephrolithotrotomy? A meta-analysis. Int J

Surg 2022; 98: 106223.https://doi.org/10.1016/j.ijsu.2021.106223.

Large T, Nottingham C, Brinkman E. Multi-Institutional

Prospective Randomized Control Trial of Novel Intracorporeal

Lithotripters: ShockPulse-SE vs Trilogy Trial. J Endourol 2021;

(9): 1326-1332. https://doi.org/10.1089/end.2020.1097.

Proietti S. Instruments. In: Hubosky, S.G., Grasso III, M., Traxer,

O., Bagley, D.H. (eds) Advanced Ureteroscopy. Springer, Cham,

https://doi.org/10.1007/978-3-030-82351-1_3.

Abd ZH, Muter SA. Comparison of the Safety and Efficacy of

Laser Versus Pneumatic Intracorporeal Lithotripsy for Treatment

of Bladder Stones in Children. J Clin Med 2022; 11(3): 513.https://doi.org/10.3390/jcm11030513.

Axelsson TA, Cracco C, Desai M. Consultation on kidney stones,

Copenhagen 2019: lithotripsy in percutaneous nephrolithotomy.

World J Urol 2021; 39(6): 1663-1670.https://doi.org/10.1007/s00345-020-03383-w.

Castellani D, Corrales M, Lim EJ. The Impact of Lasers inPercutaneous Nephrolithotomy Outcomes: Results from a

Systematic Review and Meta-Analysis of RandomizedComparative Trials. J Endourol 2022; 36(2): 151-157.

https://doi.org/10.1089/end.2021.0507.

Auge BK, Lallas CD, Pietrow PK. In vitro comparison ofstandard ultrasound and pneumatic lithotrites with a new

combination intracorporeal lithotripsy device. Urology 2002;60(1): 28-32. https://doi.org/10.1016/s0090-4295(02)01624-2.

Teichman JM, Vassar GJ, Bishoff JT, Bellman GC. Holmium:YAGlithotripsy yields smaller fragments than lithoclast, pulsed dyelaser or electrohydraulic lithotripsy. J Urol 1998; 159(1): 17-23.https://doi.org/10.1016/s0022-5347(01)63998-3.

Razvi HA, Song TY, Denstedt JD. Management of vesical calculi:comparison of lithotripsy devices. J Endourol 1996; 10(6): 559-563. https://doi.org/10.1089/end.1996.10.559.

Rabani SM, Rabani S, Rashidi N. Laser Versus PneumaticLithotripsy With Semi-Rigid Ureteroscope; A Comparative

Randomized Study. J Lasers Med Sci 2019; 10(3): 185-188.https://doi.org/10.15171/jlms.2019.29.

Maghsoudi R, Amjadi M, Norizadeh D. Treatment of ureteral

stones: A prospective randomized controlled trial on comparison

of Ho:YAG laser and pneumatic lithotripsy. Indian J Urol 2008;

(3): 352-354. https://doi.org/10.4103/0970-1591.39549.

Pietrow PK, Auge BK, Zhong P. Clinical efficacy of a

combination pneumatic and ultrasonic lithotrite. J Urol 2003;

(4): 1247-1249.https://doi.org/10.1097/01.ju.0000049643.18775.65.

Timm B, Farag M, Davis NF. Stone clearance times with minipercutaneous nephrolithotomy: Comparison of a 1.5 mm

ballistic/ultrasonic mini-probe vs. laser. Can Urol Assoc J 2021;

(1): E17-e21. https://doi.org/10.5489/cuaj.6513

Abedi AR, Razzaghi MR, Allameh F. Pneumatic Lithotripsy

Versus Laser Lithotripsy for Ureteral Stones. J Lasers Med Sci

; 9(4): 233-236. https://doi.org/10.15171/jlms.2018.42.

Joshi HN, Singh AK, Koirala NP. Outcome of Uretero

Renoscopic Lithotripsy (URSL) with Holmium LASER Vs

Pneumatic Lithotripter for Lower Ureteric Stones, Experience

from University Hospital of Nepal. Kathmandu Univ Med J 2020;

(69): 49-53

Jhanwar A, Bansal A, Sankhwar S, et al. Outcome analysis of

holmium laser and pneumatic lithotripsy in the endoscopic

management of lower ureteric calculus in pediatric patients: a

prospective study. Int Braz J Urol 2016; 42(6): 1178-1182.

http://doi.org/10.1590/S1677-5538.IBJU.2016.0211.

Downloads

Published

30-12-2023

Issue

Section

Original Articles

How to Cite

1.
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: https://pafmj.org/PAFMJ/article/view/8856