Holmium : YAG laser for urinary stones

Objective: To evaluate the results of Holmium:YAG (Ho:YAG) laser lithotrips y in the treatment of urinary stones. Material and methods: Between 1993 an d 1997, 59 patients with 85 urinary stones were treated with the Ho:YAG las er lithotripsy. Retrospective evaluation was done on the 64 procedures avai lable, comprising 53 ureteric, 8 bladder, and 2 renal calculi, and one ston e in a ureterocele. Results: The Ho:YAG laser fragmented all types of calcu li. Of 38 patients, 29 (76%) with ureteric stones were stone-free and 7 (18 %) had stone fragments smaller than 2 mm left 1-3 months after the lithotri psy, resulting in a total clinical success rate of 95%. The procedure cause d four ureteric perforations. One ureteric stricture, after repeated treatm ents for a Steinstrasse formation, led to nephrectomy. Conclusions: The Ho: YAG laser was reliable and effective for most of the urinary stones. The la rgest stones in any location, and stones of hard composition, however, were treated with combined disintegration methods. Four minor ureteric perforat ions and one ureteric stricture were related to laser use.