Anti retropulsive stone device technique during laser lithotrepsy in treatment of upper ureteric stone with their effect on stone free rate and operative time( comparative study)

Author(s): Hussein ali al-hamdani
Date: 09/10/2026
doi: https://doi.org/10.5281/zenodo.8425890

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Abstract

Background: Ureteroscopy fragmentation & extraction of ureteric stones is one of the most efficient 
minimal invasive treatment modalities, one of the drawbacks of this procedure, which occur specially 
during fragmentation of upper ureteric stones, is the proximal stone migration or retropulsion. 
Objective: To assess the safety and efficacy of different method of anti retropulsive device techique 
during laser  lithotrepsy of upper ureteric stone and their effect on stone free rate. 
Patients & Methods: This retrospective comparative study included 90 patients During the period from 
June 2025 to june 2026 90 patients, with symptomatic upper ureteral stones of greater than 10 mm in 
size were admitted in our urology unit and enrolled in this study. 
Patients were randomized into 3 equal groups; Group (A) underwent ureteroscopic laser fragmentation 
with using of stone cone, group (B) with two guide wires and group (C) underwent ureteroscopic 
fragmentation with using of single safety wire. 
Patient demographics, stone size, operative duration and complications, and success rates (complete 
stone disintegration with no upward migration) were reported and analysed statistically. 
Results: There was no significant difference in stone size, and additional procedure among different 
groups 
Stone migration was statistically significant different (p=0.008) in which (6.7%) in group A and 
(13.3%) in group B while there was high retropulsion rate in group C (36.7%), which lead to a stone 
free rates (93.3%)% in group A

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