Clinical Efficacy of Ureteroscopic Pneumatic Lithotripsy and Holmium Laser Lithotripsy in Managing Ureteral Calculi: A Propensity Score Matching Analysis

Abstract

AIM: This study aims to compare the clinical efficacy of ureteroscopic pneumatic lithotripsy (URPL) and ureteroscopic holmium laser lithotripsy (URHLL) in managing ureteral calculi (UC) using the propensity score matching (PSM) method.

METHODS: This retrospective study recruited 288 UC patients admitted to the Huzhou Traditional Chinese Medicine Hospital between October 2019 and October 2024. Based on the surgical procedure received, patients were divided into the URPL group (137 cases) and the URHLL group (151 cases). Clinical data such as gender, age, body mass index (BMI), stone location, affected side, maximum and minimum stone diameter, and the degree of hydronephrosis were collected for analysis. After 1:1 PSM matching, the surgical efficacy, perioperative parameters, oxidative stress indicators, renal function markers, and the occurrence of complications were comparatively analyzed between the two groups.

RESULTS: After PSM, 75 matching pairs were identified, and both the patient groups were found comparable for baseline characteristics. The URHLL group demonstrated significantly higher one-time gravel success and stone excretion rates (p < 0.05) and had significantly reduced operation time, less intraoperative blood loss, and shorter hospital stay (p < 0.05). After treatment, the URHLL group showed a minimal increase in oxidative stress indicators, a more pronounced decrease in renal function markers (p < 0.05), and a significantly lower overall complication rate (p < 0.05). However, no significant differences were found between the two groups regarding the re-operation rate and hospitalization costs (p > 0.05).

CONCLUSIONS: URHLL is superior to URPL in managing UC, providing improved gravel-removal and stone-expulsion, more favorable perioperative outcomes, a reduced oxidative stress response, better renal function protection, and minimal complication rate.