COMPARATIVE STUDY BETWEEN LASER LITHOTRIPSY DUSTING TECHNIQUE AND FRAGMENTATION TECHNIQUE IN UPPER URETERIC STONES

Soliman, Ahmad Mohammed; Shouman, Hossam Ahmad; Abolila, Abdelrhman Abdelghany Ebrahim Abdelghany

doi:https://doi.org/10.21608/aimj.2025.446472

COMPARATIVE STUDY BETWEEN LASER LITHOTRIPSY DUSTING TECHNIQUE AND FRAGMENTATION TECHNIQUE IN UPPER URETERIC STONES

Document Type : Original Article

Authors

¹ Assistant consultant of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

² Lecturer of Urology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

³ MBBCh., Urology Resident at Al-Azhar University Hospitals, Cairo, Egypt

https://doi.org/10.21608/aimj.2025.446472

Abstract

Background: The prevalence of Ureteric calculi is estimated to be 12% to 14% in men and 6% in women. The question of which surgical technique is optimal remains controversial and should be determined. Theoretically dusting decrease operative time and the risk of ureteral injury by avoiding the use of the ureteral access sheath (UAS). Also, dusting reduces the procedure cost by avoiding the use of stone retrieval devices.
Aim and objectives: In order to compare the efficacy and safety of the low-energy, high-frequency stone dusting approach and the high-energy, low-frequency stone fragmentation technique as they pertain to laser lithotripsy for upper ureteral stones.
Patients and methods: This prospective randomized trial was conducted on patients with upper ureteric stones and was divided into 2 groups. Group A consisted of twenty-five individuals who were subjected to dusting. The second group, known as group B, consisted of 25 patients and was subjected to Fragmentation. From June 2023 to May 2024, at the Urology Department of Al-Hussein and Sayed Galal, Al-Azhar University Hospitals in Cairo, Egypt.
Results: No perioperative complications were encountered. Stone clearance was observed in 23 (92%) & 16 (64%) patients in both groups, respectively (P 0.016). All patients with residual fragments required ancillary procedure.
Conclusion: The setting of energy and frequency have a considerable effect on stone free rate. The stone dusting technique during laser lithotripsy for upper ureteric stones is associated with lower residual stone rates and a reduced need for ancillary procedures compared to the stone fragmentation technique, while maintaining a similar safety profile. Our findings suggest that the dusting technique may be a preferred approach for the management of upper ureteric stones.

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