Video

• Publisher: John Wiley and Sons
• Year: 2005
• Tongue: English
• Weight: 78 KB
• Volume: 36
• Category: Article
• ISSN: 0196-8092
• DOI: 10.1002/lsm.20174

✦ Synopsis

Objective: Ho:YAG laser was approved for the treatment of stones in 1994. It is highly absorbable by water. The laser energy creates a vapor bubble of about 3 mm in length. To be effective to break stone, the laser fiber needs to be within this bubble. We evaluated the applicability and efficacy of the Ho:Yag laser for transurethral lithotripsy of bladder calculi. Methods and Materials: Forty-seven adult men with bladder calculi were treated with Ho:Yag cystolithotripsy. Mean age was 59 years (range 27-82). Thirty-seven patients had neuropathic bladders and 10 had outflow obstruction. Ho: YAG lithotripsy was performed using mostly 550-micron fiber threaded through a 7 F ureteric catheter for stability for its contact with the stone. The fiber length was kept constant at the cystoscope tip to gauge the depth of stone. For the larger stones initial setting was 1 to 1.5 J Â 10 HZ but for the smaller stones 0.6 to 1 J Â 10 to 15 HZ settings were used. The largest stone treated was 8 cm in maximum diameter. Results: All stones were treated to completion in one setting. In 18 patients, additional bladder neck procedures were also accomplished with Ho: YAG laser including bladder neck incisions and or transurethral sphincterotomy. Complications: Except for slight congestion of the bladder wall, no complication was encountered. The catheter was removed in 24 hours. Conclusion: The Ho: YAG laser is effective for most of the bladder stones in a single setting and is versatile to take care of the associated bladder outlet obstruction.