Holmium:Yttrium-aluminum-garnet laser cystolithotripsy of large bladder calculi

Abstract

Patients with large bladder calculi (4 cm or larger) have traditionally been managed with open cystolithotomy. Endoscopic management with cystolitholapaxy or electrohydraulic lithotripsy risks complications. In an effort to spare patients the morbidity of open cystolithotomy, the results of holmium:yttrium-aluminum-garnet (YAG) laser cystolithotripsy for bladder calculi 4 cm or larger were reviewed. Consecutive patients with bladder calculi of 4 cm or larger were managed with holmium:YAG laser cystolithotripsy. Laser energy was delivered using either the 365-micron end-firing fiber or the 550-micron side-firing fiber. Fourteen consecutive patients were managed with holmium:YAG cystolithotripsy. All patients were rendered stone free, regardless of stone composition or size. Median anesthesia time was 57 minutes. Twelve of 14 patients were discharged by the first postoperative day. The procedure times normalized for stone size (mean +/- standard deviation) for the end-firing versus the side-firing fibers were 13 +/- 6 min/cm versus 6 +/- 1 min/cm, respectively; P = 0.04. Holmium:YAG laser cystolithotripsy of large bladder calculi is effective, technically facile, and safe. The 550-micron side-firing fiber may be better suited for large bladder calculi compared with the 365-micron end-firing fiber. Holmium:YAG cystolithotripsy may obviate open cystolithotomy in selected patients.

Journal

Title: Urology

Abbreviated Title: Urology

Publisher: Elsevier BV

ISSN (Print): 00904295

Publication date Created: July 1997

Publication date (Print): July 1997

Volume: 50

Issue: 1

Pages: 44-48

Article

DOI: 10.1016/S0090-4295(97)00201-X

PubMed ID: 9218017

Copyright statement: © 1997

License:

https://www.elsevier.com/tdm/userlicense/1.0/

Product

Self URI (article page): https://linkinghub.elsevier.com/retrieve/pii/S009042959700201X