To explore the clinical efficacy of the modified ureteral rigid holmium laser lithotripsy for the treatment of upper ureteral calculi.

A total of 115 patients with unilateral unilateral ureteral stones (the distances from stones to the ureteropelvic junction≤5 cm) were selected from May 2015 to May 2017 in the Urology Department of the First Hospital of Shanxi Medical University. The modified ureteral lithotripsy (modified group, 72 cases) and traditional ureteral lithotripsy (control group, 43 cases) were performed respectively. Modified group:Inlet valve and outlet valve of ureteroscope were connected to water inlert and vacuum extractor respectively by tee joint. Patients were in the dorsal elevated and oblique supine position. Ureteroscope was catheterized with the guiding of plugging device. Operator controlled the speed of water ingress. 200 μm-fine-fiber was used during lithotripsy. After adequate drainage, furosemide was intravenous injected.There was no significant difference in age, sex, stone side, degree of hydronephrosis, distance between stones from ureteropelvic junction and stone size (P>0.05). One-stage stone clearance rate and drift rate were compared between two groups.

The stone clearance rate was 93.06% (67/72) in the modified group and 62.79% (27/43) in the control group. The difference between the two groups was statistically significant (χ²=16.52, P<0.05). The drift rate in modified group was 5.56% (4/72), and that in the control group was 41.86% (18/43). There was a statistically significant difference between the two groups (χ²=22.94, P<0.05). There was no ureteral perforation, ureteral avulsion and other serious complications during intraoperative or postoperative period.

When the improved method is used to treat upper ureteral stones, stones do not easily migrate into the renal pelvis. The clearance rate of stones in the first stage is high, and it is safe, convenient, and feasible. It is particularly suitable for primary hospitals without soft ureteroscopes.