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  • Title: [Ho-YAG laser contact lithotripsy in transurethral treatment of the concrements of the upper urinary tract].
    Author: Martov AG, Maksimov VA, Ergakov DV, Fakhredinov GA, Iarovoĭ SIu, Fatikhov RR.
    Journal: Urologiia; 2008; (5):24-8. PubMed ID: 19069491.
    Abstract:
    The article presents original experience with the treatment of 192 patients (90 males and 102 females, age 3-84 years) who have undergone transurethral laser contact lithotripsy for concrements of the upper urinary tract. Four patients received one-stage treatment for bilateral concrements. Size of the concrements detected before surgery varied from 0.6 to 2.8 cm. Pyelocalycolithotripsy and laser ureterolithotripsy were made in 42 and 154 cases, respectively. Fibropyelocalycoscopy was performed in 4 patients, the rest patients were examined with a rigid ureteropyeloscope 8 and 10 F in diameter. Contact laser lithotripsy was conducted in different regimes of laser AURIGA. The experience shows that for contact lithotripsy the regime 16-20 J, 8-12 Hz is optimal. The operation in 64.5% cases ended in internal stenting, in the rest cases postoperative drainage was conducted by ureteral catheter or nephrostomic drainage established before surgery. Postoperative treatment consisted in antibacterial, antiinflammatory and analgetic treatment under blood count control. The stones were eliminated in 88.5%, residual fragments in the kidney occurred in 11.5% patients. The fragments disintegrated due to extracorporeal lithotripsy. The most frequent complication was postoperative pyelonephritis attack (11.5%) treated conservatively. The conclusion is that universal Ho-YAG laser system AURIGA raises efficacy of endourological interventions on the upper urinary tract and decreases probability of intraoperative injury as well as postoperative complications promoting higher standards of specialized, based on high-technology urological care.
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