Laser Photofragmentation of Ureteral Calculi: Analysis of 75 Cases

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Abstract
Seventy-three patients with ureteral calculi ranging in size from 5 x 5 to 10 x 30 mm and two patients with Steinstrasse underwent lithotripsy with a pulsed tunable dye laser (504-nm wavelength; l-µsec bursts). The laser fiber was passed through a ureteral catheter or a new laser basket via a ureteroscope. In 70 cases, the patients were partially or entirely freed of stones. There were three equipment failures necessitating another form of lithotripsy, and two stones (one of brushite and one of cystine) that did not respond to laser energy and required ultrasonic lithotripsy. The laser is particularly useful in patients with impacted ureteral stones that cannot be bypassed and requires a smaller ureteroscope than does ultrasonic lithotripsy. It is now my preferred type of ureteroscopic lithotripsy unless the stone is thought to be of calcium oxalate monohydrate.

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