Holmium Laser Lithotripsy (HoLL) of Ureteral Calculi
Kuntz R, Lehrich K, Fayad A,

The effectiveness and side-effects of ureteroscopic HoLL of ureteral stones should be evaluated. In 63 patients (17 female, 46 males) a total of 75 stones of 3-20mm diameter were treated with ureteroscopic HoLL. 18.7% of stones were located in the proximal third, 24.0% in the middle third and 57.3% in the distal third of the ureter. HoLL was performed with small diameter semirigid and flexible ureteroscopes, 220 or 365nm flexible laser fibers and a holmium: YAG laser at a power of 5-15 W. (0.5-1.0 J, 10-15Hz.). 47 of 63 patients (74.6%) were immediately free of stones, and 8 others (12.6%) lost their residula fragments spontaneously within two weeks. Another 2 patients received additional chmolitholysis for uric accid stones fragments, i.e. 90.5% of patients were stone free by one sitting of ureteroscopic HoLL. Of the remaining 6 patients (9.5%) who still had residual calculi 4 weeks after HoLL, 2 asymptomatic patients refused any additional treatment, 2 patients preferred treatment with ESWL, and 2 patients had a successful second HoLL, thereby raising the success rate of ureteroscopic HoLL to 93.7%. 2 patients showed contrast medium extravastion on retrograde ureterograms, due to guide wire perforation. No ureteral stricture occurred. In conclusion, transuretheral ureteroscopic HoLL proved to be a safe and suvvessful minimal invasive treatment of ureteral calculi.

Can J Urol 2000 Feb;7(1):952-6

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