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Five years experience in experimental laser lithotripsy

W Cecchetti1, A Tasca, F Zattoni

  • 1Department of Chemistry-Physics, University of Venice, Italy.

European Urology
|January 1, 1993
PubMed
Summary
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Dye and alexandrite lasers effectively fragment various stones, with dye lasers showing promise for cystine stone lithotripsy when combined with specific solutions. Nd-YAG lasers were less effective due to fiber tip damage.

Area of Science:

  • Urology
  • Laser Lithotripsy
  • Biomedical Engineering

Background:

  • Kidney stones pose a significant health burden.
  • Effective laser lithotripsy requires optimal laser-stone interaction.
  • Different stone compositions exhibit varying responses to laser fragmentation.

Purpose of the Study:

  • To evaluate the efficacy of three laser sources (Nd-YAG, dye, alexandrite) for in vitro lithotripsy of various stone types.
  • To investigate the use of dye and alexandrite lasers for cystine stone fragmentation in the presence of specific solutions.

Main Methods:

  • In vitro lithotripsy of approximately 300 stones using Nd-YAG (1,064 nm), dye (504 nm), and alexandrite (755 nm) lasers.
  • Fragmentation of cystine stones immersed in water or solutions containing carmine indigo, methylene blue, rifamycin, or rifampicin.

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  • Spectrophotometric analysis of solutions to assess light absorption at laser wavelengths.

    • Main Results:

    • Calcium oxalate monohydrate and brushite stones were most resistant.
    • Highest fragmentation rates observed for calcium oxalate dihydrate, struvite, uric acid, and hydroxyapatite stones.
    • Dye and alexandrite lasers were generally effective; Nd-YAG lasers caused fiber tip damage.
    • Successful dye laser fragmentation of cystine stones occurred in concentrated rifamycin and rifampicin solutions.

    Conclusions:

    • Dye and alexandrite lasers are effective for lithotripsy of various stone compositions.
    • The dye laser, particularly when used with concentrated rifamycin or rifampicin solutions, shows potential for cystine stone treatment.
    • Nd-YAG lasers are less suitable for lithotripsy due to fiber tip degradation.