Place of Holmium Laser Ureteroscopy in the Management of Upper Urinary Tract Stones: Results About 82 Cases

Introduction: Laser ureteroscopy is an effective method in the treatment of upper urinary tract stones. Our hospital is equipped with semi-rigid and flexible uretroscopes, equipped with a 35-watt Storz calculasse III holmium laser generator. The objective of this study is to evaluate the results of laser ureteroscopy. Materials and methods: The study was carried out in the urology department of the Pr Bocar Sidy Sall University Hospital in Kati. It was a prospective study, which took place from December 1, 2023 to March 31, 2024. Included in our study were patients diagnosed with renal and proximal or distal ureteral lithiasis and operated by flexible or semi-rigid laser ureteroscopy. The parameters studied were: sociodemographic data, reason for consultation, urological history, number, size and topography of stones, type of urethroscopy performed, postoperative follow-up, length of hospitalization. A survey form was established for data collection. Data analysis was done on Word 2016, Excel 2016 and SPSS version 23.0 software after data verification. The anonymity of patients was guaranteed with their consent for the use of personal data. Results: We performed 82 cases of laser ureteroscopy. The average age was 36.60 years with extremes from 7 to 79 years. The male sex was the most represented (57% of cases). Renal colic was the most frequent reason for consultation (82.9%). The insertion of a double J ureteral catheter was the most represented urological antecedent in 15.9% of cases. The left lumbar ureter was the most represented side (28% of cases). In the majority of cases, the size of the stone varied between 18-28 mm (37.8%). The urine culture was positive in 18% of cases and E. coli represented 35%. Flexible laser ureteroscopy was the most performed (75.6% of cases). The stone-free rate "without residual fragment" was successful in 69 patients, or 84.1% of cases, and revision surgery was performed in 13 patients, or 15.9% of cases. The hospital stay was 1 day in 90.2% of cases. Conclusion: Laser ureteroscopy is the treatment of choice for upper urinary tract stones. The challenge lies primarily in urologists mastering this technique and acquiring the necessary equipment.