Ureteroscopic Lithotripsy Using Pneumatic Lithoclast for Treatment of Middle and Lower Ureteral Calculi: A prospective Study

Ureteral calculi is a common disease in urology that require active therapy owing to its increased prevalence, high occurrence rate, and numerous complications. Ureteroscopy is a common urologist's procedure for both diagnostic and therapeutic interventions. URS with PL is a safe and efficient procedure for managing patients who had urolithiasis especially those who had middle & lower ureteral calculi. This study compares safety and efficacy of ureteroscopic lithotripsy assisted pneumatic lithoclast in treatment of middle and lower ureteral stones. Sixty individuals were enrolled in this prospective comparative clinical research from June 2021 to June 2023. Two groups of patients were created [lower ureteric stones group (A) and middle ureteric stones group (B)]. Both groups were treated by semi-rigid ureteroscopic lithotripsy using pneumatic lithoclast. The study inclusion criteria were fulfilled by 60 patients. The mean age was 39.5 ranging from 20-56 years, 16 female patients (26.6%) and 44 male patients (73.3%). The mean size of stone for group (A) was 10.5 mm ranging from 5.9-19 mm and for group (B) was 19 mm ranging from 6-20 mm. The mean H.U for group (A) was 1012.6 ranging from 250-1700 and for group (B) was 1080 ranging from 550-1735. Free rate of stone was 93.3% in group (A) and was 86.6% in group (B). The mean time of operation for group (A), 32.59 min ranging from 18-46 min and for group (B), 33.94 min ranging from 18-60 min. Group (A) showed statistically significant higher rate of one intraoperative complication compared to group (B). Group (B) showed statistically significant higher rate of more than one intraoperative complications compared to group (A).  Ureteroscopy with pneumatic lithoclast is a secure and efficient procedure for treatment of ureteric calculi located in middle and lower parts of the ureter. However there were minor complications. We need further studies with larger scales for conforming our results.