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Comparative Study
. 2024 Sep 2;24(1):190.
doi: 10.1186/s12894-024-01576-8.

Comparison of Moses laser and Raykeen laser in patients with impacted upper ureteral stone undergoing flexible ureteroscopic holmium laser lithotripsy

Liu Haitao #  1 , Cao Ben #  2 , Chen Xin  3 , Yi Long  1 , Zhang Xu  1 , Xu Junnan  1 , Mai Haixing  4
Affiliations
Comparative Study

Comparison of Moses laser and Raykeen laser in patients with impacted upper ureteral stone undergoing flexible ureteroscopic holmium laser lithotripsy

Liu Haitao et al. BMC Urol. .

Abstract

Background: To compare the operative effect and clinical efficacy of the Moses laser mode and the Raykeen holmium laser energy platform powder mode under flexible ureteroscopic lithotripsy in patients with impacted upper ureteral stones.

Methods: From March 2022 to September 2022, 72 patients were divided into a Moses laser group and a Raykeen laser group according to surgical method, with 36 patients in each group. CT and ureteroscopy confirmed that all patients had isolated impacted upper ureteral stones. The stone volume (mm3), stone density (Hu) and severity of hydronephrosis were measured by CT. Postoperative complications were evaluated using the Clavien-Dindo score.

Results: There were no complications of ureteral stenosis related to the laser treatment. The operative time and lithotripsy time were lower in the Moses laser group than in the Raykeen laser group (P < 0.05). The stone-free survival rate did not differ significantly between the two groups (P = 0.722). Stone volume was found to be positively correlated with laser energy and lithotripsy time in both groups (P < 0.01). There was no significant correlation between laser energy and lithotripsy time or ureteral stone density (Hu) in the Moses laser group (P > 0.05) or the Raykeen laser group (P > 0.05).

Conclusions: The contact mode of Moses technology and the powder mode of Raykeen laser lithotripsy can be used for the ablation of a single impacted upper ureteral stone. The ablation speed was related to the stone volume and the severity of polyp hyperplasia, not the stone density. We recommend the use of the powdered mode as a therapeutic measure for the treatment of impacted upper ureteral stones in flexible ureteroscopic lithotripsy.

Keywords: Flexible ureteroscopic lithotripsy; Holmium laser; Moses technology; Polyps; Ureteral stone.

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Conflict of interest statement

The authors declare no competing interests.

Figures

Fig. 1
Fig. 1
Grading results for the severity of polyp hyperplasia under the flexible ureteroscope: A. Grade 1 = Mild polyp hyperplasia, i.e., more than half the size of the ureteral stone is visible; B. Grade 2 = Moderate polyp hyperplasia, i.e., no more than half the size of the ureteral stone is visible; C. Grade 3 = Severe polyp hyperplasia, i.e., complete obstruction of flexible ureteroscopic visual field, and the ureteral stone is invisible. D. Holmium laser lithotripsy for ureteral stones under a flexible ureteroscope
Fig. 2
Fig. 2
Correlation analysis in the Moses laser group: A. Relationship between laser energy and stone volume; B. Relationship between lithotripsy time and stone volume; C. Relationship between laser energy and stone density; D. Relationship between lithotripsy time and stone density; E. Relationship between lithotripsy time and polyp hyperplasia; F. Relationship between lithotripsy time and hydronephrosis
Fig. 3
Fig. 3
Correlation analysis in the Raykeen laser group: A. Relationship between laser energy and stone volume; B. Relationship between lithotripsy time and stone volume; C. Relationship between laser energy and stone density; D. Relationship between lithotripsy time and stone density; E. Relationship between lithotripsy time and polyp hyperplasia; F. Relationship between lithotripsy time and hydronephrosis
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