CT urography diagnosis and Ho:YAG laser lithotripsy for ureteral radiolucent calculi

Objective To use CT urography for diagnosis and Ho:YAG laser lithotripsy for treatment of the ureteral radiolucent calculi,so as to improve the diagnosis and treatment of ureteral radiolucent calculi.Methods A total of 60 patients,who had acute flank pain,hematuria and suspected ureteral stone on B-ultrasonography,yet with negative KUB,underwent CT urography,and they were diagnosed as having ureteral radiolucent calculi and were treated via ureteroscopy with Ho:YAG laser lithotripsy.Results CTU The CT urography in all the 60 cases clearly displayed the entire courses of ureter,including the location,size,and shape of the stones and the degrees of ureter dilatation.Forty-two calculi were located on the left side and 18 on the right side,19 at the upper part of the ureter,15 at the middle part,and 27 at the lower part.Forty-four cases were successfully fragmented after a single session of lithotripy,4 cases were fragmented by Ho:YAG laser lithotripsy via cystoscopy,and 3 cases were treated via ureteroscopy after a second Ho:YAG laser lithotripsy.Five cases with the diameters of calculi 0.5 cm were successfully treated with drug.Another 4 patients were transferred to other hospitals after a failed first session of Ho:YAG laser lithotripsy.Conclusion CTU is quick,accurate in diagnosing uretcral radiolucent calculi.Ureteroscopy with Ho:YAG laser lithotripy is an ideal treatment for the ureteral radiolucent calculi.(Shanghai Med J,2010,33:372-373)