This small prospective study examined 20 patients who were undergoing laser cystolithotripsy for bladder stones. Laser lithotripsy was performed using either a 365 or 550µm holmium:YAG laser fibre with a power setting of 1.0J and a frequency of 10Hz. Stone fragmentation was classified as complete if there was no evidence of stone at cystoscopy at the end of the procedure. The mean stone size was 2.2cm with 14 patients having a single bladder stone, two having two stones and four having multiple stones. The mean operative time was 33 minutes. Stone clearance was complete in 100% of cases. No major complications were reported. This study confirms that laser cystolithotripsy can work well for bladder stones (in this study stone size was up to 4cm). More work could be done to see if the optimal way of managing bladder stones can be determined preoperatively but it is a good technique for bladder stones with minimal mucosal trauma and reasonable operative times.
Cystolithotripsy using the holmium laser: evolving uses for the laser lithotrite
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