Ureteroscopic methods for treating patients with ureterolithiasis

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DOI: 10.29188/2222-8543-2020-12-1-58-65

Guseynov M.A., Martov A.G., Andronov A.S.
№1 2020

Introduction. At present, urolithiasis is one of the complex and relevant medical and social problems. In the Russian Federation, urolithiasis accounts for about 40% of all urological diseases in the structure of the general urological morbidity. In almost half the cases, calculi are localized in the ureter, which is due to the anatomical features of this organ.

The main methods for stone elimination during their localization in the ureters are: conservative method, including active observation, lithokinetic and chemolytic therapy, and minimally invasive methods (remote shock wave lithotripsy, endourological technique, retrograde and antegrade percutaneous ureterolithotripsy); open and laparoscopic ureterolithotomy.

Purpose. Provide a reviewof the literature and scientific publications on the use of varioustypes of energiesforthe destruction ofcalculi during ureteroscopy. Materials and methods. A literature search was conducted in the Pubmed database for the keywords: urolithiasis, ureteroscopy, ureterolithotripsy, lasers in urology, holmium laser, pneumatic ureterolithotripsy, thulium fiber laser. The search for English-language and Russian-language materials, preclinical (on animals) and clinical studies. The analysis of published articles.

Results. Currently, ureteroscopy is an effective and minimally invasive method for treating ureteral stones. In the clinical practice of a urologist, various types of energies are used to destroy ureteral stones with ureteroscopy. Currently, the urologist’s arsenal contains lithotripters that differ in their physics of calculus destruction, such as pneumatic, ultrasonic, electro-impulse, electro-hydraulic and laser ones. Over the past decade, rapid progress has been made in laser technology in urology. According to the latest recommendations of the European Association of Urology, a holmium laser is the “gold standard” for performing both rigid and flexible ureteroscopy. However, in recent years there have been many reports of lithotripsy using a thulium fiber laser, which is characterized by a high pulse frequency, efficiency and minimal retro-pulsion. This article provides a literature review of data on the advantages and disadvantages of a particular method.

Conclusions. Currently, retrograde contact ureterolithotripsy is the most effective minimally invasive method for removing clinically significant ureter stones.

Conflict of interest. The authors declare no conflict of interest.

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