DefinePK

Abstract

Background: Ureteric calculi are a common clinical concern and present a therapeutic challenge, particularly in resource-limited settings. While various global studies have documented the efficacy of pneumatic lithotripsy, there is a noticeable gap in regional data from Khyber Pakhtunkhwa, Pakistan. Given the province's socioeconomic constraints and limited access to advanced technology, semi-rigid ureteroscopy with pneumatic lithotripsy offers a cost-effective and minimally invasive treatment alternative. This study was conducted to assess its efficacy in the local population.
Objective: To determine the stone-free rate of pneumatic lithotripsy in adults diagnosed with ureteric calculi.
Methods: This descriptive study was conducted at the Department of Urology, Lady Reading Hospital, Peshawar, from January 16 to July 15, 2021. A total of 109 adult patients aged 18 to 60 years with ureteric stones confirmed on ultrasonography were enrolled using non-probability consecutive sampling. Patients with anatomical abnormalities, prior interventions in the same ureter, chronic kidney disease, or contraindications to the procedure were excluded. All patients underwent semi-rigid ureteroscopy using a Karl Storz 6.4×8.0 Fr ureteroscope under general anesthesia, with stone fragmentation performed via Swiss LithoClast pneumatic lithotripsy. Postoperative follow-up at 4 weeks included KUB ultrasound to confirm stone clearance, defined as complete absence of echogenic foci or residual fragments ≤4 mm. Data were analyzed using SPSS version 26.
Results: The mean age was 41.28 ± 10.33 years, mean stone size 33.55 ± 5.33 mm, and mean BMI 24.02 ± 2.66 kg/m². Of 109 participants, 70 (64.2%) were male and 58 (53.2%) were aged above 40 years. Stones >30 mm were observed in 66 patients (60.6%). The overall stone-free rate achieved was 85.3% (n=93).
Conclusion: Semi-rigid ureteroscopy with pneumatic lithotripsy is a safe, effective, and economically feasible option for managing ureteric stones in adults, especially in settings with limited healthcare resources.