[Laser lithotripsy of ureteral stones. Personal experiences]

The in vitro evaluation of a pulsed Nd:YAG laser, showed an effective and fine fragmentation of urinary calculi and showed only minimal subepithelial bleeding in the directly irradiated canine ureter. Since 1989 we have treated ureteral calculi in 30 patients. The laser pulses of 15-20 mJ (at fiber tip), 20 ns, 20-25 cps are transmitted by a 300-microns quartz fiber with a specially formed tip focusing the light. The fiber is passed through an 11.5-F ureteroscope within a guide tube, or, without a guide tube, through one of the new minimized ureteroscopies and is placed in front of the calculus. In 27 patients the procedure was successful, without any residual concretions after 1 day. In our opinion the advantages of this method are the very fine-grained, complete fragmentation of all sorts of calculi, the highly atraumatic procedure, and the absence of either optical or acoustic irritation to the operator.