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Thulium Fiber Laser's Dust for Stone Composition Analysis: Is It Enough? A Pilot Study.
Alba Sierra1,2, Mariela Corrales1,2, Merkourios Kolvatzis1,2
1GRC Urolithiasis no. 20 Tenon Hospital, Sorbonne University, Paris, France.
Journal of Endourology
|July 8, 2022
Summary
Analyzing urinary stone dust can reveal stone composition, aiding in understanding the lithogenic process. Surgical photos can supplement dust analysis by providing missing morpho-constitutional information.
Area of Science:
- Urology
- Biochemistry
- Medical Imaging
Background:
- Urinary stone analysis typically requires stone fragments.
- Non-invasive methods for stone composition analysis are desirable.
Purpose of the Study:
- To evaluate if urinary stone dust analysis alone can determine stone biochemical composition.
- To assess the utility of intraoperative photos for morpho-constitutional analysis of urinary stones.
Main Methods:
- Twenty patients underwent retrograde intrarenal surgery for renal stone treatment using thulium fiber laser.
- Stone dust was aspirated through the working channel, and residual fragments were collected.
- Scanning electron microscopy and Fourier transform infrared spectroscopy analyzed dust and fragments.
- Intraoperative photos of stones were captured for morphologic analysis.
Main Results:
- Dust analysis provided insights into the lithogenic process in most cases.
- In some cases, dust analysis revealed missing components or altered proportions compared to fragments.
- Intraoperative photos identified whewellite and weddellite layers, offering additional diagnostic information.
Conclusions:
- Urinary stone dust analysis is a viable method for understanding stone composition and the lithogenic process.
- Intraoperative stone imaging complements dust analysis, especially when specific morphologic details are crucial.
