The Holmium Laser in Urology

Wollin, Tim A.; Denstedt, John D.

doi:10.1089/clm.1998.16.13

Cited by 132 publications

(68 citation statements)

References 41 publications

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“…14,[21][22][23][24][25] The holmium laser is well known and has proven efficiency for urolithiasis. 26,27 However, one has to be attentive to its potential dangers, because of its absorption characteristics in the surrounding tissues and because of the heat generated from the fragmentation within the narrow salivary ducts. The holmium laser should be used only under clear vision, tangential to the duct, and only in cases of sialolithiasis.…”

Section: Discussionmentioning

confidence: 99%

Submandibular Diagnostic and Interventional Sialendoscopy: New Procedure for Ductal Disorders

Marchal¹,

Dulguerov²,

Becker³

et al. 2002

Ann Otol Rhinol Laryngol

154

118

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We present our initial experience with submandibular sialendoscopy, a new therapeutic approach for disorders of Wharton's duct. We review the sialendoscopes used and discuss their respective merits. We evaluated and treated 129 consecutive patients with suspected ductal disorders. Diagnostic sialendoscopy was used for classifying ductal lesions as sialolithiasis, stenosis, sialodochitis, or polyps. Interventional sialendoscopy was used to treat these disorders. The type of endoscope used, the type of sialolith fragmentation and/or extraction device used, the total number of procedures, the type of anesthesia, and the number and size of the sialoliths removed were the dependent variables. The outcome variable was the endoscopic clearing of the ductal tree and resolution of symptoms. Diagnostic sialendoscopy was possible in 131 of 135 glands (97%), with an average (±SD) duration of 28 ± 15 minutes. Interventional sialendoscopy was attempted in 110 cases, with an average duration of 71 ± 41 minutes, with a success rate of 82%. Multiple sialendoscopies were necessary in 25% of cases. General anesthesia was used in 12% of cases. Submandibular gland resection was performed in 4%. The average size of the stones was 4.9 ± 2.9 mm. Multiple sialoliths were found in 31 cases (29%). Sialolith fragmentation was required in 26%. Larger and multiple stones often required longer and multiple procedures and general anesthesia, and more often resulted in failures. Semirigid endoscopes had a higher success rate (85%) than flexible sialendoscopes (54%). Complications were mostly minor, but were encountered in 10% of cases. Diagnostic sialendoscopy is a new technique for evaluating salivary duct disorders that is associated with low morbidity. Interventional sialendoscopy allows the extraction of sialoliths in most patients, thus preventing open gland excision.

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Section: Discussionmentioning

confidence: 99%

Submandibular Diagnostic and Interventional Sialendoscopy: New Procedure for Ductal Disorders

Marchal¹,

Dulguerov²,

Becker³

et al. 2002

Ann Otol Rhinol Laryngol

154

118

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“…11,18 The zone of thermal injury by holmium laser is 0.5 to 1mm. 19 Therefore, holmium laser can be used near to the mucosal surface. Stone composition has minimal effect on the outcome of stone fragmentation.…”

Section: Discussionmentioning

confidence: 99%

Outpatient Transurethral Cystolithotripsy of Large Bladder Stones by Holmium Laser

et al. 2016

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Introduction: To assessment of the efficacy and safety of transurethral cystolithotripsy of large bladder stones by holmium laser in the outpatient setting. Methods: In a prospective study, 48 consecutive adult patients with large bladder stones, were enrolled for transurethral cystolithotripsy. Patients older than 18 years, with bladder stones larger than 2 cm were enrolled. Urethral stricture, active urinary infection, and any anesthetic contraindications for operation, were the exclusion criteria. Demographic characteristics of patients, outcomes and complications related to operation and post operation period, were recorded. Results: Patients mean age was 46 ± 7.3 years. Male to female ratio was 45/3. Mean body mass index of patients was 28.5 ± 3.5. Mean stone size was 3.7 ± 1.6 cm. Mean operation time was 43.5 ± 15.5 minutes. Nearly complete stone clearance (98.5%) was achieved in all patients. Mean hospital stay was 6.5 ± 1.3 hours. No major complications were seen. Mean visual analog pain score (VAS) was 4.2 ± 2.1 and 1.4 ± 0.6, during and 1 hour after operation, respectively. During follow up of 22.4 ± 12.5 months, recurrence of bladder stone was not seen. No case of urethral stricture was detected. Conclusion: Transurethral holmium laser lithotripsy is an effective and safe alternative in selected patients with large bladder stones. This procedure can be easily performed in the outpatient setting.

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“…The Holmium: YAG laser has the ability to fragment calculi of all compositions including calcium oxalate monohydrate and it is an ideal intracorporeal lithotripter for ureteral calculi with a high success rate and low morbidity (19). Moreover, the Holmium: YAG laser has haemostatic properties that would be beneficial for treating patients with bleeding disorders (20). Therefore, it is ideal for fulguration of bleeders during biopsy of ureteral lesions in patients with coagulopathies.…”

Section: Discussionmentioning

confidence: 99%

Ureteroscopy in patients with coagulopathies is associated with lower stone-free rate and increased risk of clinically significant hematuria

2012

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The Holmium Laser in Urology

Abstract: The holmium: YAG laser is a multi-purpose, multi-specialty surgical laser. It has been shown to be safe and effective for multiple soft tissue applications and stone fragmentation. Its utilization in urology is anticipated to increase with time as a result of these features.

Cited by 132 publications

References 41 publications

Submandibular Diagnostic and Interventional Sialendoscopy: New Procedure for Ductal Disorders

Submandibular Diagnostic and Interventional Sialendoscopy: New Procedure for Ductal Disorders

Outpatient Transurethral Cystolithotripsy of Large Bladder Stones by Holmium Laser

Ureteroscopy in patients with coagulopathies is associated with lower stone-free rate and increased risk of clinically significant hematuria

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