Page 58 - TheTalents 2018 Debate7
P. 58
• Int Braz J Urol 2017
Dusting – A.C.L. Neto /// Fragmentation – A.Meller
1)
Generation of powder or little fragments;
• minimizing the risk of recurrence and future complications;
The best approach is to reduce stone burden in bigger stones (over 10mm) with dusting technique and fragmenting the residual stone (less than 10mm) in pieces to be retrieved, combining both techniques.
When treating smaller stones, fragmentation seems to meet the goal to achieve immediate stone-free status.
2) Lower costs;
• No baskets
• spares the laser fiber, with less tip degradation.
• It is possible not to use the ureteral sheath
3) Lower retropulsion of ureteral calculi; • reducing the risk of migration to
the kidney and inefficiency of the
procedure.
I believe that dusting must be the initial choice for intracorporeal lithotripsy.
