Holmium laser cystolithotripsy under local anaesthesia: Our experience

Dsouza, Nischith; Verma, Ashish

doi:10.1016/j.aju.2016.06.002

Cited by 10 publications

(6 citation statements)

References 10 publications

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“…On the other hand, they discovered no di culties throughout the follow-up period of six months. According to our short-term follow-up data, it was found that no stone recurrence was discovered in our study [59]. Based on our research and that of Agawal et al, we advise using a transurethral resectoscope with a high power laser setting for more effective fragmentation of urinary stones.…”

Section: Discussionsupporting

confidence: 61%

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

Wang

Sun

2022

Preprint

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Backgrounds To compare the effectiveness and safety of high-power (100 W) vs. low-power (20 W) laser settings for transurethral laser lithotripsy in the treatment of urethral stones. Methods The trial was open to all patients scheduled for transurethral holmium laser lithotripsy who had urethral stones with the maximal diameter. Either the low-power laser setting or the high-power laser setting was applied to every substitute patient. Using IBM SPSS Statistics 24, we compared the treatment groups' operational times, intraoperative/postoperative problems (up to 1 year), and stone-free rates. Welch tests were used to compare continuous data across treatment groups, whereas Fisher's exact or Chi-square tests were used to evaluate categorical variables. Statistical significance was defined as a p value 0.05. Results Two hundred seven people were hired as a result. Both groups' preoperative data and mean bladder stone sizes were similar. When compared to the low-power cohort, the procedure took much less time—42.6111.74 min as opposed to 78.5625.91 min (p = 0.025)—and the ablation rate was significantly higher in the high-power cohort. In neither group were there any substantial intraoperative issues. High power group considerably outperformed low power group in terms of OABSS score and IPSS. According to results of uni- and multivariate logistic regression, the position of the ureteral stone significantly affects how well the therapy works. Conclusion When treating urethral stones, a high-power laser setting of up to 100 W significantly reduces the length of the procedure without increasing the risk of complications.

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Section: Discussionsupporting

confidence: 61%

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

Wang

Sun

2022

Preprint

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“…Again in the same study, authors concluded that open surgery presents higher complication rates than the endoscopic approach (19). Currently, it is well known that open surgery is the technique of choice for limited indications such as cases with oversized bladder stones or those, who are scheduled to undergo simultaneous prostatectomy or diverticulotomy (20). In obese patients, on the other hand, open surgical approach should be the last resort in our opinion.…”

Section: Resultsmentioning

confidence: 87%

Our experience of laser lithotripsy under local anesthesia in the treatment of bladder stones in obese male patients

Kölükçü

Parlaktaş

Kölükçü

et al. 2021

Journal of Health Sciences and Medicine

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Introduction: Our century has witnessed a significant increase in obesity, which in its turn, bears several major risks in management of systemic anesthesia. In this context, use of this treatment without general or regional anesthesia is of critical importance for patients under this group. Aim: In present study, it was aimed to analyze the efficacy and safety of holmium laser lithotripsy (HLL) under local anesthesia in obese male patients with bladder stones. Material and Method: In our study, we evaluated a total of 64 obese male patients with body mass index (BMI) ≥30 kg/m2, diagnosed with bladder stones and treated HLL under local anesthesia. Demographic data, stone size, operative time, urethral catheterization time and length of hospital stay of the patients were analyzed. Visual Analogue Scale (VAS) scores was calculated for each patient during the procedure. Complications were graded according to modified Clavien classification system. Results: The mean age of patients was 50.58±13.04 years and BMI was 33.46±2.59 kg/m2. Mean stone size was 2.51±1.04 cm and operative time was 43.91±15.92 minutes. None of the patients had severe pain and the mean VAS score was calculated as 2.31±1.02. Mean length of hospital stay was 1.25±1.04 days. Grade 3 or higher complications were not observed according to modified Clavien classification system. Mean urethral catheterization time was 1.56±1.45 days, although varying due to underlying etiological factor. All patients were stone-free and there was a marked improvement in clinical findings. Conclusion: Use of HLL under local anesthesia is a safe and efficacious approach in obese male patients with bladder stone.

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“…The stones fragmented with the Ho:YAG laser can be retrieved by Ellik evacuator/ Toomy glass syringe wash or can pass spontaneously. 28,29 But the quality of dust and fragmentation attained with TFL is far minute compared to HO: YAG laser, thus obviating the need for the wash or extraction of the stone. This was our observation as all our patients with stones <20 mm passed the stone dust spontaneously and completely as was evident on the follow-up ultrasound which documented 100% stone clearance.…”

Section: Discussionmentioning

confidence: 99%

Thulium fiber laser cystolithotripsy under local anesthesia: A day care procedure

et al. 2023

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Introduction: Bladder stones account for 5% of all urolithiasis. Patients present with LUTS or acute urinary retention. Thus, warranting an early intervention. Minimally invasive approach with laser lithotripsy is the present gold standard to treat bladder stones. Aims and objectives: To evaluate the outcomes of TFL (60 W) for bladder stones performed under local anesthesia as a day-care procedure. Materials and methods: This was a retrospective single-center study conducted after obtaining IRB approval. Study period was between June 2021 and June 2022 were included. All patients were operated under local anesthesia as a day care procedure. The procedure was carried out using an 18 Fr laser sheath and calculus dusted using TFL energy (15–30 W). Parameters including operative time in minutes, complications were recorded. Patients were encouraged oral and normal voiding in the immediate post-op period. Results: A total of 47 patients with bladder stones presented during this period. Of these, 30 underwent laser lithotripsy (TFL) for bladder calculi. The clinical presentation of patients was LUTS in 28 (93%) and 5 (16%) patients had AUR. The average size of the stone in this series was 15 ± 2.8 mm. The mean duration of laser lithotripsy was 15 ± 5.4 min. Energy to dust the stone was variable with mean LASER energy of 18.23 ± 10 W. All patients tolerated the procedure well and none required conversion to conventional anesthesia. One patient failed to void in the post-op period. 100% clearance rate was documented in all patients. Conclusion: Thulium fiber laser for transurethral cystolithotripsy of bladder stones under local anesthesia is a feasible technique with minimal morbidity and good outcome.

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Holmium laser cystolithotripsy under local anaesthesia: Our experience

Cited by 10 publications

References 10 publications

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

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

Our experience of laser lithotripsy under local anesthesia in the treatment of bladder stones in obese male patients

Thulium fiber laser cystolithotripsy under local anesthesia: A day care procedure

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