[Ureteral lithotripsy with rigid ureteroscopy and pulsed dye laser]

Pulsed dye laser lithotripsy represents nowadays a new approach to ureteral stones. 27 patients were treated with a pulsed dye laser unit (Pulsolith TM) at our department from november 1989 to january 1990. 21 had a single stone and the remaining a multiple ureteral lithiasis. The pulsed dye laser operated at a wave length of 504 nm, energy ranged between 90 and 160 mj with pulse of 1,5 ms. A 320 theta diameter quartz fiber with Helium Neon red laser (to visualize the top of the fiber) introduced in a rigid 9.5 ureteroscope (Wolf) was used during the procedure. Spinal, peridural or general anesthesia was done in all patients and the time of the procedure ranged between 8-150 minutes. Fiber was inserted in a 4 Ch ureteral catheter which provided easier manipulation of the fiber. Complete fragmentation was achieved in 88.9% of the patients, and combined manoeuvres were requested in another 3.7%. Failures were 7.4%. Minimal lesions of the ureter, due to ureteroscope advancement subsided spontaneously after placement of double F catheter. Pulsed dye laser lithotripsy seems to be a safe and useful procedure for treatment of impacted ureteral calculi and seems to offer low morbidity in respect of ultrasonic or electrohydraulic procedures especially when the stone location does not permit an ESWL approach.