Samer Morsy, Ahmed Essam, Islam Nasser, Mohamed Elsheikh, Sherif Abdel Rahman, Kareem Daw
{"title":"输尿管软性镜检查中输尿管近端结石的碎石治疗:一项前瞻性随机研究。","authors":"Samer Morsy, Ahmed Essam, Islam Nasser, Mohamed Elsheikh, Sherif Abdel Rahman, Kareem Daw","doi":"10.1097/CU9.0000000000000285","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Recent advances in endoscopic technology have empowered urologists to treat most types of stones within the urinary tract effectively. Available treatments for ureteral stones using a laser lithotripter include fragmentation, the active removal of fragments with a basket, and dusting. To date, only a few prospective randomized studies have endorsed the use of stone dusting, fragmentation, and active removal for ureteric stones.</p><p><strong>Materials and methods: </strong>This randomized, prospective, comparative study was conducted in the Urology Department. Sixty patients with proximal ureteral stones from July 2019 to July 2020 were included and randomly divided into 2 groups using a random number generator program (version 2, 2015). In Group 1, the stones were fragmented into dust (n = 30), and in Group 2, lithotripsy produced extractable fragments (n = 30).</p><p><strong>Results: </strong>In this study, the Ho:YAG laser was used to dust stones at low energy and high frequency (0.4-0.6 J and 20-30 Hz). Using the Ho:YAG laser set to high energy and low frequency (1.5-2 J and 8-10 Hz), stone fragmentation was achieved. The mean stone size was 1.63 cm in Group 1 and 1.69 cm in Group 2. The stone-free rates for the dusting and fragmentation groups were 96.6% and 86.6%, respectively. Meanwhile, the mean operative time was 87.6 ± 33.6 minutes in the dusting group and 80.4 ± 28.8 minutes in the fragmentation group. There were no postoperative complications with the dusting technique, compared with a 13.3% complication rate with the fragmentation technique.</p><p><strong>Conclusions: </strong>For proximal ureteral stones, the stone-free rates between the dusting and fragmentation procedures were comparable. Both techniques proved to be effective.</p>","PeriodicalId":39147,"journal":{"name":"Current Urology","volume":"19 4","pages":"257-262"},"PeriodicalIF":1.3000,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321463/pdf/","citationCount":"0","resultStr":"{\"title\":\"Dusting versus fragmentation for large proximal ureteral stones during flexible ureteroscopy: A prospective randomized study.\",\"authors\":\"Samer Morsy, Ahmed Essam, Islam Nasser, Mohamed Elsheikh, Sherif Abdel Rahman, Kareem Daw\",\"doi\":\"10.1097/CU9.0000000000000285\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Recent advances in endoscopic technology have empowered urologists to treat most types of stones within the urinary tract effectively. Available treatments for ureteral stones using a laser lithotripter include fragmentation, the active removal of fragments with a basket, and dusting. To date, only a few prospective randomized studies have endorsed the use of stone dusting, fragmentation, and active removal for ureteric stones.</p><p><strong>Materials and methods: </strong>This randomized, prospective, comparative study was conducted in the Urology Department. Sixty patients with proximal ureteral stones from July 2019 to July 2020 were included and randomly divided into 2 groups using a random number generator program (version 2, 2015). In Group 1, the stones were fragmented into dust (n = 30), and in Group 2, lithotripsy produced extractable fragments (n = 30).</p><p><strong>Results: </strong>In this study, the Ho:YAG laser was used to dust stones at low energy and high frequency (0.4-0.6 J and 20-30 Hz). Using the Ho:YAG laser set to high energy and low frequency (1.5-2 J and 8-10 Hz), stone fragmentation was achieved. The mean stone size was 1.63 cm in Group 1 and 1.69 cm in Group 2. The stone-free rates for the dusting and fragmentation groups were 96.6% and 86.6%, respectively. Meanwhile, the mean operative time was 87.6 ± 33.6 minutes in the dusting group and 80.4 ± 28.8 minutes in the fragmentation group. There were no postoperative complications with the dusting technique, compared with a 13.3% complication rate with the fragmentation technique.</p><p><strong>Conclusions: </strong>For proximal ureteral stones, the stone-free rates between the dusting and fragmentation procedures were comparable. Both techniques proved to be effective.</p>\",\"PeriodicalId\":39147,\"journal\":{\"name\":\"Current Urology\",\"volume\":\"19 4\",\"pages\":\"257-262\"},\"PeriodicalIF\":1.3000,\"publicationDate\":\"2025-07-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12321463/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Current Urology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1097/CU9.0000000000000285\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/19 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q4\",\"JCRName\":\"UROLOGY & NEPHROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Current Urology","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1097/CU9.0000000000000285","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/19 0:00:00","PubModel":"Epub","JCR":"Q4","JCRName":"UROLOGY & NEPHROLOGY","Score":null,"Total":0}
Dusting versus fragmentation for large proximal ureteral stones during flexible ureteroscopy: A prospective randomized study.
Background: Recent advances in endoscopic technology have empowered urologists to treat most types of stones within the urinary tract effectively. Available treatments for ureteral stones using a laser lithotripter include fragmentation, the active removal of fragments with a basket, and dusting. To date, only a few prospective randomized studies have endorsed the use of stone dusting, fragmentation, and active removal for ureteric stones.
Materials and methods: This randomized, prospective, comparative study was conducted in the Urology Department. Sixty patients with proximal ureteral stones from July 2019 to July 2020 were included and randomly divided into 2 groups using a random number generator program (version 2, 2015). In Group 1, the stones were fragmented into dust (n = 30), and in Group 2, lithotripsy produced extractable fragments (n = 30).
Results: In this study, the Ho:YAG laser was used to dust stones at low energy and high frequency (0.4-0.6 J and 20-30 Hz). Using the Ho:YAG laser set to high energy and low frequency (1.5-2 J and 8-10 Hz), stone fragmentation was achieved. The mean stone size was 1.63 cm in Group 1 and 1.69 cm in Group 2. The stone-free rates for the dusting and fragmentation groups were 96.6% and 86.6%, respectively. Meanwhile, the mean operative time was 87.6 ± 33.6 minutes in the dusting group and 80.4 ± 28.8 minutes in the fragmentation group. There were no postoperative complications with the dusting technique, compared with a 13.3% complication rate with the fragmentation technique.
Conclusions: For proximal ureteral stones, the stone-free rates between the dusting and fragmentation procedures were comparable. Both techniques proved to be effective.