Efficacy of stone cone in ureteroscopic pneumatic lithoclast for lower ureteric stone.

Abstract

Objective: To evaluate the efficacy and safety of stone cone during ureteroscopic pneumatic lithoclast for lower ureteric stone. Study Design: Comparative Cross-sectional study. Setting: Department of Urology Jinnah Hospital, Lahore. Period: July 2025 to December 2025. Methods: Comparative Cross-sectional study. Methods: Included 125 patients with lower ureteric stones. Patients were randomly divided into two groups: Group A (Stone Cone, n=63) and Group B (Control, n=62). All patients underwent ureteroscopic fragmentation using a pneumatic lithoclast. Outcomes measured included stone-free rate, incidence of retropulsion, operative time, auxiliary procedures, postoperative complications as well as hospital stay. Statistical analysis was performed using SPSS, with p ≤ 0.05 considered significant. Results: Stone retropulsion was significantly lower in the Stone Cone group (3.2% vs 17.7%, p=0.009). The stone-free rate was higher in Group A (96.8% vs 82.3%, p=0.008). Mean operative time (31.8 ± 6.4 vs 38.9 ± 7.6 min, p<0.001) and hospital stay (1.4 ± 0.6 vs 2.1 ± 0.8 days, p<0.001) were significantly shorter in the Stone Cone group. The need for auxiliary procedures was also reduced (3.2% vs 16.1%, p=0.015). Conclusion: The use of Stone Cone during ureteroscopic pneumatic lithoclast for lower ureteric stones significantly improves stone-free rates, reduces retropulsion, shortens operative time and decreases the need for secondary procedures. Stone Cone is a safe, effective and cost-efficient, particularly valuable in resource-limited settings.