THE HOLMIUM LASER IN UROLOGY

Objective: To review the physics related to the holmium laser, its las er-tissue interactions, and its application to the treatment of urolog ical diseases. Summary and Background Data: The holmium:YAG laser is a solid-state, pulsed laser that emits light at 2100 nm, It combines th e qualities of the carbon dioxide and neodymium:YAG lasers providing b oth tissue cutting and coagulation in a single device, Since the holmi um wavelength can be transmitted down optical fibers, it is especially suited for endoscopic surgery. Methods: The authors provide a review of the literature as it relates to the holmium laser and its applicati on to urology. Results: The holmium wavelength is strongly absorbed by water. Tissue ablation occurs superficially, providing for precise in cision with a thermal injury zone ranging from 0.5 to 1.0 mm, This lev el of coagulation is sufficient for adequate hemostasis, The most comm on urologic applications of the holmium laser that have been reported include incision of urethral and ureteral strictures; ablation of supe rficial transitional cell carcinoma; bladder neck incision and prostat e resection; and lithotripsy of urinary calculi, Conclusions: The holm ium:YAG laser is a multi-purpose, multi-specialty surgical laser, It h as been shown to be safe and effective for multiple soft tissue applic ations and stone fragmentation. Its utilization in urology is anticipa ted to increase with time as a result of these features.