Objective To compare the efficacy and safety between holmium laser lithotripsy by flexible ureteroscope and rigid ureteroscopic lithotripsy combined with basket extraction of ureteral stone in treating upper ureteral calculus.

Methods The clinical materials of 145 patients with single upper ureteral calculus treated by transurethral ureteroscope were analyzed retrospectively. A total of 74 patients with rigid ureteroscopic lithotripsy and basket extraction of ureteral stone were named as control group, and 71 patients treated by holmium laser lithotripsy with flexible ureteroscope after purchasing electronic ureteroscope were named as observation group. The operation time, success rate of lithotripsy, escape rate of calculus, ureteral injury, residual stone rate at 2 weeks after operation, intraoperative bleeding and infection rate were compared between the two groups.

Results In the control group, 10 cases failed to intercept due to the upward movement of calculus, which required indwelling ureteral stents combined with extracorporeal lithotripsy and drug lithotripsy; holmium laser lithotripsy was successfully performed in the Ⅱ stage in the observation group after the ureteral stent was placed for expansion in the Ⅰ stage. The escape rate of calculus, success rate of lithotripsy and the average operation time in the observation group were significantly higher and longer than those in the control group (P < 0.05). There were no significant differences in the intraoperative bleeding, ureteral injury rate and postoperative infection rate between the two groups (P>0.05).

Conclusion In the treatment of upper ureteral calculus with holmium laser, the efficacy of flexible ureteroscope is better than that of rigid ureteroscope combined with basket extraction of ureteral stone, but the safety of the two operation methods is equivalent.