Efficacy of Electrohydraulic Lithotripsy v Laser Lithotripsy in the Ureter

  • Thomas W. Schoborg

Abstract

Since endourological procedures were first introduced at the Atlanta Stone Center in 1982, electrohydraulic lithotripsy (EHL) has been utilized to fracture 62 ureteral calculi, via antegrade (percutaneous) or retrograde (ureteroscopic) techniques. Using a 5 Fr. or a 3 Fr. probe, success was achieved in 60 cases (97%). Intravenous pyelograms were performed in 60 patients after treatment, and only one revealed mild hydronephrosis. Six perforations of the ureter and two ureteral stone extrusions were managed conservatively with good results.

Recently, having incorporated pulsed dye laser as an alternative modality to manage ureteral calculi, 22 patients with ureteral stones have been treated at the center. Via either an antegrade or a retrograde approach, 20 stones (91%) were considered successfully fractured. Intravenous pyelograms were performed in only two patients, and both were normal. There were no perforations directly attributed to the laser probe. The two failures were calcium oxalate monohydrate stones.

In summary, both modalities proved safe and efficacious. There is a significant cost difference favoring electrohydraulic lithotripsy; however, at this time the laser probe offers the advantages of more flexibility and a smaller diameter.

Keywords

Laser Fiber Calcium Oxalate Ureteral Stone Ureteral Calculus Laser Lithotripsy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Manegold BC, Mennieken C, Jung M: Endoscopic electrohydraulic disintegration of common bile duct concrements. Presented at V World Congress of Digestive Endoscopy, Stockholm, 1982.Google Scholar
  2. 2.
    Reuter HJ and Kern E: Electronic lithotripsy of ureteral calculi. J Urol 110: 181, 1973.PubMedGoogle Scholar
  3. 3.
    Raney A: Electrohydraulic ureterolithotripsy. Urology 12: 284, 1978.PubMedCrossRefGoogle Scholar
  4. 4.
    Clayman RV, Miller RP, Reinke DB, et al: Nephroscopy: advances and adjuncts. Urol Clin NAm 9: 59, 1982.Google Scholar
  5. 5.
    Green DF and Lytton B: Early experience with direct vision electrohydraulic lithotripsy of ureteral calculi. J Urol 133: 767, 1985.PubMedGoogle Scholar
  6. 6.
    Green DF and Lytton B: Electrohydraulic lithotripsy in the ureter. Urol Clin NAm 15: 361, 1988.Google Scholar
  7. 7.
    Kahn RI: Endourological treatment of ureteral calculi. J Urol 135: 239, 1986.PubMedGoogle Scholar
  8. 8.
    Willscher MK, Comvey JF, Bobayan RK, et al: Safety and efficacy of electrohydraulic lithotripsy by ureteroscopy. J Urol 140: 957, 1988.PubMedGoogle Scholar
  9. 9.
    Schoborg TW, Jeffries B, Rodriguez AP, et al: Percutaneous removal of stones in the kidney and ureter. J Med Assoc GA 72: 615, 1983.PubMedGoogle Scholar
  10. 10.
    Dretler SP: Techniques of laser lithotripsy. J Endourol 2: 123, 1988.CrossRefGoogle Scholar
  11. 11.
    Segura JW and Patterson DE: Use of the Candela laser in the ureter. Urol Clin NAm 15: 365, 1988.Google Scholar

Copyright information

© Springer Science+Business Media New York 1989

Authors and Affiliations

  • Thomas W. Schoborg
    • 1
  1. 1.Atlanta Stone CenterGeorgia Baptist Medical CenterAtlantaUSA

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