PTU - Polskie Towarzystwo Urologiczne
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Application of holmium laser energy for desintegration of ureteral stones in an outpatient setting
Article published in Urologia Polska 2008/61/2.


Piotr Humański, Piotr Dykczyński
Oddział Urologii Jednego Dnia Niepublicznego Zakładu Opieki Zdrowotnej Specjalista w Kutnie


ureter urinary stone disease ureteral stone endoscopy lithotripsy holmium laser


Introduction and the aim of the study. Urolithiasis appears to be a very common disease among the population of developed
countries, thus absorbing a significant part of activity performed by urologists worldwide. One of the therapeutic options, frequently
used by urologists is an intracorporeal lithotripsy via an endoscopic approach (URSL). The aim of the study was to assess the clinical
efficacy of intracorporeal lithotripsy by means of Holmium Laser device in an outpatient setting.
Material and method. 136 patients were treated in an outpatient mode from 2004 to 2006 in our ward. The Holmium Laser was
applied for intracorporeal lithotripsy via an endoscopic approach using a 600 µm laser fiber. The size and location of the stones were
noted, as well as laser energy used for desintegration of the stones and accessory equipment used each time.
Results. 136 cases were analysed, the age varied from 20 to 78 years (the average of 50), among them 66 female and 70 male.
The stone location was the upper ureter in 68 (50%) cases and lower ureter in 68 (50%). The average stone diameter was 10mm
4 to 25 mm
to evacuate the stone fragments was used in 81 cases (60%). The traditional ureteral catheter was left in 79 cases (58%), while the
double-J catheter was used in eight (6%). The ureteral wall damage was observed in four patients (3%); it was successfully treated in
a conservative manner in three of them.
Conclusions. The stone desintegration by means of the Holmium Laser is a very effective and reliable way of intracorporeal lithotripsy
and the procedure is feasible in all parts of the ureter. Ureteral wall damages – if they appear – are not deep or vast, due to superficial
penetration of the laser beam and can be managed successfully by means of conservative treatment. Holmium Laser appears to be a
very effective tool in an outpatient ureteroscopic lithotripsy.


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