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Holmium:YAG laser ureterolithotripsy.

R M Scarpa1, A De Lisa, D Porru

  • 1Clinica Urologica, Scuola di Specializzazione in Urologia, Università degli Studi di Cagliari, Ospedale SS. Trinità, Cagliari, Italy. roscarpa@tin.it

European Urology
|March 11, 1999
PubMed
Summary

The holmium:yttrium-aluminum-garnet (Ho:YAG) laser effectively fragments all ureteral stones. This laser lithotripsy offers a high clearance rate with minimal ureteral damage when using thin instruments.

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Area of Science:

  • Urology
  • Laser technology in medicine
  • Nephrolithiasis treatment

Background:

  • Ureteral stones pose a significant clinical challenge.
  • Minimally invasive treatment options are continually sought for ureteral stone disease.

Purpose of the Study:

  • To evaluate the efficacy and safety of holmium:yttrium-aluminum-garnet (Ho:YAG) laser ureterolithotripsy in a large cohort of patients.
  • To assess the stone-free rate and potential complications associated with Ho:YAG laser treatment for ureteral stones.

Main Methods:

  • A retrospective review of 150 consecutive cases of ureteral stone disease treated with Ho:YAG laser.
  • Stones were located in the lower, medium, and upper thirds of the ureter.
  • Treatment utilized a Ho:YAG laser (8-10 W, 6-10 Hz) with thin (7-Fr) or ultrathin (4.8-Fr) ureteroscopes.

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Main Results:

  • Ho:YAG laser effectively fragmented all types of ureteral stones, including calcium dihydrate and monohydrate stones.
  • A high stone clearance rate of 92.6% was achieved within a 30-day follow-up period.
  • No significant ureteral wall damage was observed; minor mucosal lacerations or coagulations occurred in a few cases but had no clinical relevance.

Conclusions:

  • The Ho:YAG laser is a highly effective tool for fragmenting all ureteral stone compositions.
  • Its use with thin or ultrathin ureteroscopes facilitates treatment and minimizes ureteral trauma.
  • Careful manipulation of the Ho:YAG laser ensures safety, preserving ureteral mucosa and wall integrity.