Comparison of Outcomes of Pneumatic Ballistic Lithotripsy, Holmium Laser Lithotripsy, and Combined Electromagnetic with Ultrasonic Lithotripsy during Percutaneous Nephrolithotomy

• Published in: Pakistan Armed Forces medical journal Vol. 73; no. 6; pp. 1725 - 1728
• Main Authors: Ejaz, Mansoor, Saulat, Sherjeel, Qadri, Syed Saeed Uddin, Ayub, Awais
• Format: Journal Article
• Language: English
• Published: Rawalpindi Knowledge Bylanes 31-12-2023; AsiaNet Pakistan (Pvt) Ltd; Army Medical College Rawalpindi
• Subjects: Catheters; Complications; Diabetes; Fever; Hematuria; Hypertension; Kidney stones; Kidneys; Laser lithotripsy; Lasers; Lithotripsy; Pain; Pneumatic lithotripsy; Postoperative period; Shock waves; Stone clearance; Success; Trilogy lithotripsy; Ultrasonic imaging; Urinary tract diseases; Urogenital system; Urological surgery
• ISSN: 0030-9648; 2411-8842
• DOI: 10.51253/pafmj.v73i6.8856

Objective: To compare outcomes of combined electromagnetic with ultrasonic lithotripter, pneumatic ballistic lithotripter, and holmium laser lithotripter among patients at a Tertiary Care Hospital.
Study Design: Prospective comparartieve study.
Place and Duration of Study: Department of Urology at Tabba Kidney Institute, Karachi Pakistan, from May 2020 to Jun 2021.
Methodology: Ninety patients were divided into three groups of lithotripsy energies. Group-A (n=30) patients got pneumatic lithotripsy, Group-B (n=30) patients got laser lithotripsy, while Group-C (n=30) patients got trilogy lithotripsy technique. Outcomes such as post-operative pain, post-operative complications, and stone clearance were evaluated in all groups.
Results: The overall mean age of the patients was 50.23±9.24 years, ranging from 33-74 years. The majority of the participants were males (n=52,57.8%), and 38(35.6%) of the participants were females. The intra-operative time, severity of post-operative pain, fever and UTI were the same between the three groups. However, the proportion of hematuria (p=0.001) and stone clearance (p=0.025) significantly differed between the three groups.
Conclusion: Laser and pneumatic lithotripter were more effective in complete stone clearance than trilogy lithotripter. While laser lithotripter significantly decreases the occurrence of hematuria.