Quantification of Joules in Various Indications of Holmium:YAG Laser in Urinary System
Lee D, Bagley D, Das A

INTRODUCTION: Our goal was to quantify the amount of joules used in treatment of various indications of the holmium YAG laser.

METHODS: Our experience with the holmium YAG laser use in 576 cases was reviewed and classified by indication and number of kilojoules used. The use for urinary calculi and transitional cell carcinoma was stratified by size.

RESULTS: The cases are summarized in the table below.

Indication	Cases	HoYAG (range) kJ	ND YAG (range) kJ
Total	576	3.78(0.01-441)	8.4(0.01-229.11)
Stone	303	5.56(0.01-441.00)
Calyceal tic	3	0.5(.24-.75)
Hemangioma	2	1.6(0.96-2.24)
Stricture	13	2.03(0.41-11.22)
Suture	2	0.09(0.03-0.14)
Tumor	228	1.52(0.01-15.28)	8.68(0.01-229.11)
Ho TURP	20	177.6(40.7-214.9)
UPJ22		1.63(0.43-7)

When size is considered for tumors and stones, generally the larger the lesion the more joules are used. However, stones above 1 cm on average do not differ greatly in the energy used. Larger tumors seem to require much greater neodymium YAG energy than holmium YAG energy to treat.

CONCLUSION: These numbers should act as a general guideline for the amount of joules used for frequent indications. The specific usage for each individual case is of course dependent on many factors such as composition of calculi and accessibility of lesion.

Journal of Endourology, Vol. 13 Supplement 1, A102, Sep 1999

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