Comparison of the clinical efficacy of holmium and thulium ureterolithotripsy

Introduction. Urolithiasis is one of the most common pathologies in modern urology. This disease is registered in 10% of the population and is manifested by an annual increase. Despite all the effectiveness and safety of Ho:YAG, in recent years, the thulium laser has attracted more and more interest. At the moment, in the modern literature there is not enough information about thulium and holmium ureterolithotripsy. The aim of this study is to compare the effectiveness of thulium and holmium ureterolithotripsy. Material and Methods. Since from October 2018 to October 2019 in City Centre Endoscopic Urology and New Technologies Clinical Hospital of St. Luke; St. Petersburg, 420 patients underwent contact ureterolithotripsy with using of thulium (group Б) or holmium (group А) lasers for calculi localized in the ureter. Results. Patients in group B had an advantage in terms of such indicators as the time of surgery, the time of lithotripsy in the Dusting and Fragmentation modes for ureteral calculi of any localization compared with group A. The SFR level in the two groups was relatively identical. Patients in group B had a lower rate of retropulsion during lithotripsy compared to patients in group A. And also in group B there was no migration of calculus into the renal cavity system. Conclusion. Our data indicate the same level of stone free rate when using both thulium and holmium lasers in the dusting and fragmentation modes. However, there is a higher efficiency during ureterolithotripsy using a thulium laser compared to ureterolithotripsy using a holmium laser, regardless of the lithotripsy mode.