Application of Catheter-Assisted Circulation System in Ureteroscopic Holmium Laser Lithotripsy

<b><i>Objective:</i></b> Ureteroscopic lithotripsy (URSL) is the main method for treating ureteral calculi. The scholars used ureteroscopes with dual channels and access sheath to reduce the local temperature and flushing fluid pressure. This study compares the efficacy and safety of ureteral catheter-assisted URSL (UCA-URSL) and traditional URSL in treating ureteral calculi. <b><i>Patients and Methods:</i></b> A cross-regional retrospective case-control study in China, including 217 intention-to-treat patients from the First Affiliated Hospital of Kunming Medical University and Tongji Hospital Affiliated to Tongji Medical College of Huazhong University of Science and Technology, from August 2023 to July 2024. The primary outcome was the temperature of the lithotripsy point. The secondary outcomes included stone-free rate (SFR), operation time, hospital stay, and postoperative complications. <b><i>Results:</i></b> Compared with the traditional URSL group, the catheter-assisted URSL group had a significantly lower lithotripsy point temperature (max, 37.9 ± 2.60°C <i>vs</i> 49.98 ± 5.04°C, <i>p</i> < 0.0001; mean, 32.3 ± 3.25°C <i>vs</i> 38.56 ± 2.70°C, <i>p</i> < 0.0001). In addition, the UCA-URSL group showed higher absolute SFR (immediately, 89.81% <i>vs</i> 53.21%, <i>p</i> < 0.0001; 3 months, 99.07% <i>vs</i> 72.48%, <i>p</i> < 0.0001), and reduced operation time (22.74 ± 7.08 minutes <i>vs</i> 26.40 ± 6.72 minutes, <i>p</i> = 0.0001), postoperative fever rate (1.85% <i>vs</i> 15.60%, <i>p</i> = 0.0003), and ureteral stricture rate (0% <i>vs</i> 3.67%, <i>p</i> = 0.04). <b><i>Conclusions:</i></b> In treating ureteral calculi, UCA lithotripsy shows better safety than traditional URSL. Catheter-assisted URSL can be used to improve traditional URSL.