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Initial experience with endoscopic holmium laser lithotripsy for pediatric urolithiasis
P P Reddy1, D J Barrieras, D J Bägli
1Division of Pediatric Urology, Hospital for Sick Children, University of Toronto, Ontario, Canada.
The Journal of Urology
|October 19, 1999
Summary
Holmium:YAG laser lithotripsy is a safe and effective treatment for pediatric urolithiasis. This study shows it successfully removed stones in all patients, offering a precise alternative to traditional methods.
Area of Science:
- Urology
- Pediatric Urology
- Endourology
Background:
- Pediatric patients often lack specialized endoscopic lithotripsy instruments.
- Advances in laser lithotripsy have not been fully accessible to children.
- The holmium: YAG laser presents a potential solution for pediatric urolithiasis treatment.
Purpose of the Study:
- To evaluate the indications for holmium: YAG laser lithotripsy in children.
- To assess the efficacy of holmium: YAG laser lithotripsy in pediatric patients.
- To determine the complication rate associated with holmium: YAG laser lithotripsy in pediatric urolithiasis.
Main Methods:
- Retrospective review of all pediatric laser lithotripsy cases.
- Utilized a solid-state holmium: YAG laser for calculus treatment.
- Calculus access was achieved via antegrade or retrograde approaches.
Main Results:
- Eight pediatric patients (ages 4-14) underwent holmium: YAG laser lithotripsy.
- Average calculus surface area ranged from 14 to 1,645 mm².
- All patients achieved stone-free status, with 5 requiring a single procedure; no complications were reported.
Conclusions:
- Holmium: YAG laser lithotripsy is a safe and effective treatment for pediatric urolithiasis.
- The laser's precision and minimal energy scattering reduce tissue trauma and residual fragments.
- This technique offers an alternative for pediatric stone treatment, leading to stone-free outcomes and stable renal function.