A prospective evaluation of high- and low-power holmium laser settings for transurethral lithotripsy in the management of adults with large bladder calculi

Bhat, Abhishek; Katz, Jonathan E.; Banerjee, Indraneel; Blachman‐Braun, Ruben; Alter, Kevin; Shah, Rashmi; Smith, Nicholas A.; Shah, Hemendra N.

doi:10.1007/s00345-021-03617-5

Cited by 6 publications

(2 citation statements)

References 26 publications

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“…Bhat et al . conducted a prospective clinical study to compare LP to HP bladder lithotripsy utilizing Ho:YAG lithotripsy [ 9 ]. Ten patients were treated with LP settings and were compared to ten patients who underwent HP bladder lithotripsy.…”

Section: Discussionmentioning

confidence: 99%

“…In their clinical trial, Bhat et al . reported clear superiority of HP bladder lithotripsy with 100 W, as it demonstrated reduced operative time without affecting the complication rate [ 9 ]. In contrast, HP settings have been described to increase irrigation fluid temperatures and carry potentially harmful effect on the bladder [ 10 ].…”

Section: Introductionmentioning

confidence: 99%

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High-power Holmium:Yag lithotripsy in bladder urolithiasis: Is it safe and effective? A combined clinical and experimental study

Pagonis,

Katsakiori,

Peteinaris

et al. 2024

Arab Journal of Urology

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Objective To evaluate the efficacy and safety of Holmium: Yttrium-Aluminum-Garnet (Ho:YAG) laser in bladder lithotripsy using high-power settings > 100 W. Materials and Methods A combined experimental and clinical study was conducted. The Quanta Cyber: Ho 150 with a 550 μm Quanta optical fiber was utilized in all set-ups. Ablation rates for soft and hard artificial stones were tested in vitro using 100 W and 20 W power settings. In the experiment, a porcine bladder was used. The optical fiber was inserted through a rigid cystoscope, whilst a K-type thermocouple was inserted in the bladder dome. The tested high-power settings were 152 W, 120 W and 105 W. In every trial, the lasing time was over 60 s. In the clinical study, 35 patients underwent transurethral high-power bladder lithotripsy. Laser settings were set between 100 W and 150 W. Results Stone mass (stone weight) was significantly lower after stone ablation independently of the stone type or the laser settings. Significantly higher mass decrease and ablation rate were detected in high-power compared to low-power settings. In the experiment, the highest temperature recorded was 32°C at 152 W. At 120 W and 105 W, the peak temperatures didn’t reach 30°C. In the clinical study, a stone-free rate of 100% and a mean operative time of 43 ± 18 min were reported. All patients stayed in the hospital for one day except for one who presented minor hematuria. Additional complications did not occur. Conclusion Ho:YAG laser lithotripsy > 100 W is an effective, fast and safe modality for the treatment of bladder calculi.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%