Holmium:YAG laser treatment of ureteral calculi: a 5-year experience

The purpose of this study was to provide an account of the 5-year experience we have gained using holmium:yttrium–aluminium–garnet (Ho:YAG) lasertripsy in the treatment of ureteral stones. One-hundred thirty-seven transurethral ureterolithotripsies were performed in 131 patients. A Ho:YAG laser device, fibres with diameters of 360 and 550 μm, a video camera as well as semi-rigid and flexible ureterorenoscopes were used. Results showed that the direct success rates—which meant stone-free ureters on the first post-operative day—in the upper, middle and lower ureters were 84.6, 88.7 and 94.8%, respectively. The final success rates—which meant stone-free ureters 4 weeks after the operation without a second intervention—were 84.6, 96.7 and 96.7%, respectively. The pulsatile Ho:YAG laser beam fragmented all kinds of stones easily. No ureteral stricture or reflux was identified during the follow-up period. The advantages of Ho lasertripsy outweighed its disadvantages. Based on our experience, the Ho:YAG laser is one of the most effective and safest energy sources in the treatment of ureteral calculi.