Holmium Laser Lithothripsy of Ureteral Calculi: Our Initial Experience

Aim: To evaluate effectiveness and safety of intracorporeal holmium:YAG (Ho:YAG) laser lithotripsy of ureteral calculi. Patients and Methods: Between October 2003 and September 2005, 45 patients (age range 27–74, mean age 51.5 years) with 49 ureteral stones (measuring 4–28 mm in size) were treated with Ho:YAG laser lithotripsy. The locations of the stones in the ureter were: 6 in the upper third, 7 in the middle third, and 36 in the lower third. Under general anaesthesia, we used semirigid 9- to 11-Fr ureteroscopes and a flexible 7.5-Fr ureteroscope. The Ho:YAG laser had a maximum power of 1.8 J at 8 Hz, and a 365-µm flexible quartz fibre was used. One month postoperatively the patients were followed up with imaging tests. Results: Stone disintegration was feasible in all cases. The mean hospital stay was 2.8 days. One month postoperatively, stone-free status was revealed in 93.3% of the cases. Only minor complications were noted in 4 patients (8.8%). No long-term complications were recorded. Conclusion: Ho:YAG laser lithotripsy of ureteral calculi is a feasible, safe, and effective procedure.