Munich, Germany (UroToday.com) Ureteroscopy is becoming one of the most often used treatment modalities for urolithiasis. Laser settings are very important for optimal stone free outcomes during the procedure. There are two setting that are most commonly used and debated among urologists. Dusting using low power high frequency laser setting and fragmentation using high power low frequency settings.
Gamal Saad and colleauges performed a study to compare two setting in the setting of ureteroscopy for renal stone less than 2cm using flexible ureteroscopy.
All patients with a single less than 2cm kidney stones were randomized into two groups. Group 1 (23 case) in which the stones were dusted using low power (0.2-0.4 Jouls) high frequency laser session(20-30 HZ) and group 2 (23 cases) in which the stones were fragmented using a high power (1-2 Jouls) low frequency (4-5 HZ) laser session. The stone free rate, the operative time, the use of access sheath and any intraoperative complication were evaluated.
All procedures were successfully completed with no complications. The stone free rate was 86% in group 1 and 89% in group 2. Group 2 had significantly longer operative times compared to group 1. The operative time was 57+_ 9 minutes in group 1 and 73+_ 13 minutes in group 2 (statistically significant p=0.001). No access sheath was used in group 1 but used in all cases of group 2. Single
Ureteroscopic use of laser in both setting is safe and efficacious in stones less than 2cm.
Presented By:
Gamal Saad W.
From the 31st Annual EAU Congress - March 12 - 15, 2016 – Munich, Germany