Impact of Pulse Mode on Dusting Effect for Holmium Laser Lithotripsy: In Vitro Evaluation With Calcium Oxalate Monohydrate Stones

Khajeh, Nikta Rezakahn; Black, Kristian M; Daignault‐Newton, Stephanie; Hall, Tim; Roberts, William W.; Ghani, Khurshid R.

doi:10.1016/j.urology.2021.08.042

Cited by 4 publications

(2 citation statements)

References 30 publications

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“…Also, in this study, we used a fixed long pulse mode only while to be more standardized, other pulse modes must be considered as the study carried by Rezakahn Khajeh et al [ 21 ], which was in vitro study that assessed the impact of pulse modes on dusting of calcium oxalate monohydrate stones.…”

Section: Discussionmentioning

confidence: 99%

The optimal Holmium laser settings for disintegration of cystine and calcium oxalate monohydrate stones: In vitro study

Zeinelabden,

El-Shazly,

Elsheerif

et al. 2024

Arab Journal of Urology

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Objective Disintegrating cystine and calcium oxalate monohydrate stones present a formidable challenge owing to their hardness and distinct composition. This study aimed to establish optimal laser settings for these hard stones lithotripsy. Patients and Methods Cystine and calcium oxalate monohydrate stones were extracted from two patients. Two experiments were conducted in vitro by utilizing a 272 μm laser fiber with variable settings to disintegrate the cystine and calcium oxalate monohydrate stones. In the first experiment, energy was adjustable while frequency was constant, whereas the second experiment involved constant energy with adjustable frequency on each type of stone and each experiment was repeated three times to ensure robustness and reliability. Results Our findings indicated that for cystine stones, use of higher total power with high energy and low frequency proved to be effective. Conversely, for calcium oxalate monohydrate stones, settings involving higher total power with low energy and high frequency demonstrated superior efficacy and safety. Conclusion Holmium (Ho: YAG) laser settings with higher total power, high energy, and low frequency effectively disintegrate cystine stones despite increased heat, which was measured by a thermometer with a thermocouple. For calcium oxalate monohydrate stones, higher total power, high frequency, and low energy settings are recommended and safe.

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Section: Discussionmentioning

confidence: 99%

The optimal Holmium laser settings for disintegration of cystine and calcium oxalate monohydrate stones: In vitro study

Zeinelabden,

El-Shazly,

Elsheerif

et al. 2024

Arab Journal of Urology

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“… 21 , 22 Long term indwelling of a double J stent can stimulate the urethral mucosa as a foreign body, and infection is more likely if aseptic conditions are not maintained during the operation. 23 Larger stone diameter is also a risk factor as they are more difficult to discharge, which increases the degree of urinary system obstruction, hydronephrosis, and subsequently, the risk of secondary infection. 24 Additionally, operation time is also a risk factor for nosocomial infection after FURSLL, as longer operation times extend exposure time of the urinary system to bacteria.…”

Section: Discussionmentioning

confidence: 99%

A predictive model of nosocomial infection in patients with upper urinary tract stones after flexible ureterorenoscopy with laser lithotripsy: A retrospective study

Xu,

2023

Pak J Med Sci

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Objectives: To construct a predictive model of nosocomial infection in patients with upper urinary tract (UUT) stones after flexible ureterorenoscopy with laser lithotripsy (FURSLL). Methods: Medical records of 196 patients with UUT stones who underwent FURSLL in Suzhou Hospital of Integrated Traditional Chinese and Western Medicine from December 2019 to December 2022 were retrospectively analyzed. Patients were divided into infected group or uninfected group based on the presence of infection during postoperative hospitalization. Univariate and multivariate logistic regressions were used to identify risk factors of postoperative nosocomial infections. A nomogram prediction model was constructed using R software. The predictive ability of the model was assessed using the receiver operating characteristic (ROC) curve. Results: A total of 54 patients (27.6%) developed nosocomial infections after FURSLL. Logistic regression analysis showed that older age, diabetes, preoperative urinary system infection, ureteral stricture, hydronephrosis, double J-stent retention time, and stone diameter were risk factors of nosocomial infection. The nomogram model was constructed based on these risk factors. The ROC showed that the area under the curve (AUC) of the model was 0.930 (95% CI: 0.890-0.970), and the sensitivity and specificity were 92.6% and 81.7%, respectively, indicating that the prediction model was effective. Conclusions: Risk of nosocomial infection in patients with UUT stones after FURSLL is affected by older age, diabetes, preoperative urinary system infection, ureteral stenosis, hydronephrosis, double J-stent retention time, and stone diameter. The nomogram prediction model, constructed based on the above factors, has good predictive value. doi: https://doi.org/10.12669/pjms.40.3.8855 How to cite this: Xu Y, Xu P. A predictive model of nosocomial infection in patients with upper urinary tract stones after flexible ureterorenoscopy with laser lithotripsy: A retrospective study. Pak J Med Sci. 2024;40(3):---------. doi: https://doi.org/10.12669/pjms.40.3.8855 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Advances in lasers for the minimally invasive treatment of upper and lower urinary tract conditions: a systematic review

Kronenberg,

Cerrato,

Juliebø-Jones

et al. 2023

World J Urol

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Impact of Pulse Mode on Dusting Effect for Holmium Laser Lithotripsy: In Vitro Evaluation With Calcium Oxalate Monohydrate Stones

Cited by 4 publications

References 30 publications

The optimal Holmium laser settings for disintegration of cystine and calcium oxalate monohydrate stones: In vitro study

The optimal Holmium laser settings for disintegration of cystine and calcium oxalate monohydrate stones: In vitro study

A predictive model of nosocomial infection in patients with upper urinary tract stones after flexible ureterorenoscopy with laser lithotripsy: A retrospective study

Advances in lasers for the minimally invasive treatment of upper and lower urinary tract conditions: a systematic review

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