الفهرس 
Title : Effect of laser lithotripsy in upper and middle ureteric stones from 0 .5 to 3 cm dusting versus fragmentation
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المستخلص
Introduction:The holmium YAG laser has become the preferred lithotripter device because of its high efficacy and the availability of small-diameter (200 æm) flexible laser fibers. It allows the urologist to control laser settings (energy and frequency) to adjust the power that is delivered at the tip of the laser fiber. Low energy (0.8-1 J), high frequency (12{u2013}15 Hz) lithotripsy results in dusting. On the other hand, higher energy levels (1.5{u2013}2 J) with lower frequencies (8{u2013}10 Hz) results in fragmentation. (1) Aim: compare between holmium YAG laser dusting versus fragmentation in the treatment of upper and middle ureteric stones from 0.5 to 3 cm by changing frequency and energy levels. Patient and methodology : This is a prospective comparative randomized study was conducted at urology department, Cairo University from 15/5/2019 to 15/5/2020. Sixty patients were included and were divided randomly into two groups. group (A) included 30 patients who underwent dusting (Low energy (0.8-1 J), high frequency (12{u2013}15 Hz)). group (B) fragmentation (higher energy levels (1.5{u2013}2 J) with lower frequencies (8{u2013}10 Hz)) and included 30 patients. Result: Mean age was 38.30 in group (A) and 40.47 in group (B). Mean stone burden was 1.63 in group (A) and 1.69 in group (B). Mean operative time more in group (A): 1.57 than in group (B): 1.28 but with insignificant difference. the residual stones were reported in 5 cases (8.3%) from total patients, one in group (A) (3.3%) and 4 in group (B) (13.3%) with no significant difference. No complications were reported in group (A) but fragmentation had mild ureteric mucosal injury in one case, small perforation requires DJ fixation in 2 cases and stone migration in one case with no significant difference