Endolum Inalholmium Laser Lithotripsy For Ureteral And Bladder Calculi

Objective To evaluate the clinical effect of holmium laser lithotripsy under ureteroscope or cystoscope for the treatment of ureteral and bladder calculi. Method A total of 89 cases of ureteral or bladder calculi were treated with holmium laser kithotripsy under ureteroscope or cystoscope between June 2004 to September 2006 in department of urology of Qilu Hospital of Shandong University.With energy 0.5～1.5J/5～15HZ ,the ureteroscope or cystoscope was directly inserted into the urethra with its tip reaching the caculus . Then the optical fiber was introduced to deliver holmium laser pulse to the calculus until it wasfragmented .Accompanied polyps or stricture were treated with holmium laser vaporization or ablation at the same time . Postoperatively, the double-J tube drainage time was 2-4 weeks and the indwelling catheter was 1-3 days. In cases treated with holmium laser enucleation of prostate, a standard three -cavity catheter was placed and was removed 1 week postoperatively.Result 13 cases of bladder stone and 3 cases of posterior urethral stone were successfully fragmented after a pressing session, success rate 100%. The operation time of bladder stone was 20-210 min (mean, 55 min); the operation time of posterior urethral stone was 10-90 min (mean, 44 min). The overall successful stone fragmentation rate of ureteral calculi was 94.5% (69/73), the operation time of ureteral calculi was 15-150 min (mean 44 min).Postoperative pyrexia occurred in 3 cases(3.4%). No major complications such as uretera and bladder perforation wereencountered.Conclusion Endoluminal holmium laser lithotripsy is an effective and safe methodfor uretera and bladder stone.