Abstract:

Objective  To evaluate the clinical effect of modular flexible ureteroscopy combined with Holmium laser lithotripsy for upper urinary calculi. Methods  48 cases of upper urinary calculi were treated with Holmium laser lithotripsy through a modular design and semi-disposable flexible ureteroscope. The pig-tai1 stent would be set into ureters of 33 case more than 1 week before the operation. The diameter of the stones ranged from 1.0 to 2.5cm.Flexible ureteroscope was used during the procedure with or without the placement of a ureteral access sheath. The stones were fragmentized and removed by 200μm Holmium laser(1.0～1.5J/10～20Hz). The follow-up was carried on 8 weeks after the procedure to evaluate the result of the endoscopic lithotripsy. Results  The successful rate of the ureteroscopic insertion was 100％.The successful rate of stone search was 93.7％(45/48).The successful rate of stone fragmentation after the single session was 95.5％(43/45). The total evacuation rate of the calculi was 73.3％(33/45).Operation time ranged from 30 to 180min. Average of hospital stay after the operation was 4 days. No severe complications occurred. Conclusion  Holmium laser lithotripsy through modular flexible ureteroscope is a safe and effective treatment modality for upper urinary calculi, especially for those with minor diameter.

Key words: Flexible ureteroscopy; Holmium laser; Upper urinary calculi; Minimally invasive treatment