Modular flexible ureteroscopy combined with holmium laser lithotripsy for treatment of renal calculi: report of 47 cases

Objective To evaluate the clinical effect of modular flexible ureteroscopy combined with holmium laser lithotripsy for treatment of renal calculi. Methods A total of 47 patients with renal calculi were treated with modular flexible ureteroscopy combined with Ho: YAG laser lithotripsy in our hospital from November 2012 to May 2013. There were 8 cases with stones in middle and upper calyx,16 cases in lower calyx,20 cases in renal pelvic and 3 cases in multiple calyxes. The calculi diameter ranged from 5. 0 to 30. 0( 16. 0 ± 4. 0) mm. Flexible ureteroseopy was used to find renal calculus under epidural anesthesia. The stones were fragmentized and removed by using 200 μm Ho: YAG laser fiber,and holmium laser lithotripsy was used at a maximum energy of 0. 8- 1. 0 J( 15- 20 Hz /12- 20 W). F5 or F6 double-J tube was postoperatively indwelled routinely. Examination was done with kidney and upper bladder( KUB) radiography within 3 days after operation,and re-examination with B-ultrasonography or KUB in 4 weeks after operation for the evaluation. Results The rate of stone detection was 91. 5%( 43 /47) and the success rate of lithotripsy was 93. 2%( 41 /44) after one operation. The operation time was 65- 155( 125 ± 16) min. Conclusion Modular flexible ureteroscopy combined with holmium laser lithotripsy has high efficiency and low complication rate,and is an effective and safe treatment for treatment of renal calculi.