Holmium Laser Lithotripsy for Urinary Calculi: A Retrospective Analysis from a Tertiary Hospital in Abuja, Nigeria

Over the last decade, Holmium: YAG (Ho: YAG) laser has emerged as the gold standard for the intracorporeal treatment of urinary tract calculi. However, this technology is not readily available in most public-owned hospitals in Nigeria. This study aims to retrospectively document our experience with the efficacy and safety of Ho: YAG laser lithotripsy for urinary calculi at the Federal Medical Centre, Abuja.

We reviewed all patients who underwent laser lithotripsy at FMC Abuja from April 2021 to October 2025. We deployed 600 μm, 365 μm, and 272 μm fibers with power settings of 50W, 10W, and 20W, respectively, for the lithotripsy of bladder, ureteral, and renal stones. Data recorded include the size, density, location of the stone, and clinical presentations and outcomes.

A total of 111 patients underwent laser lithotripsy during the study period. Ages ranged from 18 to 67 years, with a mean age of 40.28 ± 12.3 years. The male-to-female ratio was 2:1. Of the patients, 45 (40.5%) had ureteral stones, 38 (34.2%) had renal stones, 17 (15.3%) had bladder stones, and 8 (7.2%) presented with calculi in both the kidney and ureter. Flank pain was the most common presentation (n = 62, 55.9%). Right-sided stones were predominant (n=49, 44.1%), while 18 (16.2%) had bilateral stones. The mean stone density was 968.68 HU (range: 566 - 1502). The mean post-operative hospital stay was 2.61 ± 1.34 days, with a stone clearance rate of 90.1%. Postoperative complications included fever (n=16, 14.4%), stent pain (n =3, 2.7%), and ureteric perforation (n=1, 0.01%).

The Holmium laser is a safe and effective modality for lithotripsy in our setting, associated with minimal postoperative complications. Further data will be necessary to substantiate this conclusion.