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Techniques in endoscopic lithotripsy using pulsed dye laser.

M Grasso1, M Shalaby, M el Akkad

  • 1Department of Urology, Jefferson Medical College, Thomas Jefferson University, Philadelphia, Pennsylvania.

Urology
|February 1, 1991
PubMed
Summary
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The pulsed dye laser effectively fragments ureteral calculi, including challenging calcium oxalate stones. This minimally invasive technique shows promise for treating stones and associated bilharzial strictures.

Area of Science:

  • Urology
  • Endourology
  • Laser Lithotripsy

Background:

  • Ureteral calculi present a significant clinical challenge.
  • Minimally invasive treatment options are continually being explored.

Purpose of the Study:

  • To evaluate the efficacy of the pulsed dye laser for ureteral calculi fragmentation.
  • To assess the use of laser technology in conjunction with standard ureteroscopic instruments.

Main Methods:

  • A pulsed dye laser system with interchangeable optical fibers (200-400 micrometers) was employed.
  • Eighty patients with ureteral calculi were treated endoscopically using various ureteroscopes (6.9F-12.5F).
  • Specific fragmentation techniques (3-point, shear off-center) were utilized based on stone composition.

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Main Results:

  • All visualized ureteral stones were successfully fragmented.
  • Over 60% of fragmented stones were pure calcium oxalate monohydrate.
  • 30% of patients presented with bilharzial strictures, treated with balloon dilatation and dilators.

Conclusions:

  • The pulsed dye laser is a viable tool for ureteral calculi treatment, adaptable to different stone types.
  • The technology allows for effective stone fragmentation and management of associated ureteral strictures.
  • Variations in laser energy and pulsation aid in stone disimpaction and fragment control.