Endoscopic lithotripsy with the holmium : YAG laser

Background and Objective: The holmium:YAG (Ho:YAG) laser can be used not on ly for soft tissue but also for hard tissue such as urinary calculi. The ob jective of this study was to assess the usefulness of the Ho:YAG laser for endoscopic lithotripsy in patients with urinary tract stone. Study Desigin/Materials and Methods: Of 102 procedures performed among 96 p atients, 88 were transurethral ureterolithotripsy (TUL), seven were percuta neous nephrolithotripsy, and seven were transurethral cystolithotripsy. Six patients had bilateral stones. The fragments were reduced as much as possi ble with the Ho:YAG laser. Results: The efficacy rate of the 102 lithotripsy procedures was 93%. With respect to the effect of TUL, the efficacy rates of 40 procedures for the p roximal ureter, 18 procedures for the midureter, and 30 procedures for the distal ureter were 85%, 94%, and 100%, respectively. Conclusion: The Ho:YAG laser produced a sufficiently strong lithotripsy for ce on all stones. The results of this study indicate that lithotripsy of ur inary tract stones with the Ho:YAG; laser can achieve a clinical outcome eq uivalent to or exceeding that of pulsed dye laser lithotripsy. The Ho:YAG; laser is a multipurpose laser and thus is a cost effective and very useful means for endoscopic lithotripsy of urinary tract stones. Lasers Surg. Med. 25:389-395, 1999. (C) 1999 Wiley-Liss, Inc.