Background and Purpose: We reviewed our experiences with ureteroscopic pneumatic lithotripsy (URS-PL) for the treatment of distal-ureteral stones and investigated whether failed extracorporeal shockwave lithotripsy(SWL) is a limiting factor for the ureteroscopic procedure.
Patients and Methods: We retrospectively studied the medical records of 375 patients treated with URS-PL from January 1999 to September 2005 in our clinic. Of these patients, 213 were treated with URS-PL primarily(group 1), whereas the remaining 162 patients had undergone SWL unsuccessfully before URS-PL was performed (group 2). We used 9F or 9.5F rigid instruments and the Vibrolith (Elmed, Ankara, Turkey).
Results: In group 1, 206 patients (96.7%) were treated successfully with URS alone, as were 155 patients(95.6%) in group 2. Impacted stones were observed in 21 patients in group 1 (9.85%) and in 57 patients in group 2 (35.1%). The average operating time was 33.19 ± 9.039 minutes in group 1 and 57.42 ± 8.757 minutes in group 2. The stone-free rates of the two groups were significantly different on the first postoperative day, but this difference decreased to an insignificant level at the end of the first month.
Conclusion: When SWL fails, URS-PL is as safe and effective as primary URS. Pneumatic lithotripsy also seems to be effective for impacted stones.
