Effect of transurethral holmium YAG laser in treatment of bladder calculi / 中国基层医药

Objective To investigate the effect of transurethral holmium YAG laser in treatment of bladder calculi.Methods F5 laser fiber in the holmium YAG laser was used to treat 40 patients with bladder calculi.Then the effect was observed.Results All 40 cases were successfully done by the operation time range from 15 to 120 minutes.There were no major complications,such as TRUS,bladder rupture or major bleeding.There was no residue stone.Conclusion F5 laser fiber in the holmium YAG laser treatment could be protected by the transurethral scope.It was safe,effective and has shorter operation time in treatment of bladder calculi.

Ureteral calculi treated with transureteroscopic Holmium:YAG laser lithotripsy (report of 105 cases) / 中国康复理论与实践

@#ObjectiveTo evaluate the effect of transureteroscopic Holmium:YAG laser lithotripsy on ureteral calculi.Methods105 cases of ureteral stones were treated by transureteroscopic Holmium:YAG laser lithotripsy. The transverses of stones were 4～15 mm and the vertical lengths were 5～25 mm.ResultsSuccessful lithotripsy was achieved on one session in 98 cases (95%), with the stones completely expelled within 2～6 weeks. Complications occurred in 4 cases and stones moved up in 3 cases.ConclusionThe transureteroscopic Holmium:YAG laser lithotripsy is an effective and safe method for ureteral calculi.

Combination Therapy of Intraurethral Condyloma Acuminatum with Holmium: YAG Laser and 5-Fluorouracil Instillation / 대한남성과학회지

PURPOSE: Condyloma acuminatum is a common sexually transmitted disease of the external genitalia and anus. Approximately 5% of patients demonstrate urethral involvement. Electrical fulguration or excision using a pediatric resectoscope has been used in the management of such lesions. Holmium(Ho):YAG laser, 5-FU(fluorouracil), or interferon may be helpful in eradicating them. We reviewed the results of intraurethral condyloma acuminatum treatment with Ho:YAG laser and 5-FU solution. MATERIALS AND METHODS: From January 2001 to July 2002, seven patients with intraurethral condylomata acuminata were enrolled in the study. The mean age of the subjects was 19.5(range 25~43) years. Under local anesthesia with 10% lidocaine spray and jelly, all of the intraurethral lesions were removed with the Ho:YAG laser followed by coverage with 10mL of 5% 5-FU solution. Intraurethral injection of 5-FU was performed weekly up to six times. Urethroscopy for detection of recurrence was done 3 months after initial laser therapy. RESULTS: Most patients had multiple intraurethral lesions. Six patients (86%) responded to initial therapy without local recurrence with a mean follow-up of 15.8 (range 9.1-23.2) months. One patient had a recurrence at 2 months. CONCLUSIONS: We believe that the Ho:YAG laser plus 5% 5-FU solution is a useful option for the treatment of intraurethral condyloma acuminatum.

Holmium:YAG Laser Coagulation in the Female Patients of Voiding Symptom with Pseudomembranous Trigonitis

PURPOSE: Pseudomembranous trigonitis is a common cystoscopic finding in the female patients with voiding symptoms. We evaluated the changes in voiding symptoms of the patients after coagulating this lesion with Holmium:YAG laser. MATERIALS AND METHODS: Six female patients with voiding symptoms including frequency, dysuria, lower abdominal pain who were refractory to the conservative treatment for more than 1 month were enrolled in this study. The mean age was 35(range: 26~43) years. The patients were treated with cystoscopic evaluation and Holmium:YAG laser with 365 and 500 micrometer probe fibers. Power setting was between 6 and 11 watts. Only the lesions at the trigone and bladder neck were coagulated. No indwelling urethral catheter was used postoperatively. We evaluated patient's symptoms with out-patient follow-up or telephone up to 16 months. RESULTS: The mean duration of symptoms were 3.8(range: 6 months~13 years) years, and the mean follow-up was 13.3(range: 8~16) months. In all cystoscopic evaluations, pseudomembranous trigonitis was seen. After treatment, 3 of the 6 patients showed symptomatic improvements within 3 months and retained the improved state up to the last follow-up period. However, in the other 3 patients, no change in symptoms or initial response with following recurrence was seen. In the 3 patients who showed good response, transient worsening period of 1~3 months preceded the improvement. Follow-up cystoscopy at 3 months showed complete regeneration of the trigone and bladder neck mucosa. CONCLUSION: In the patients of pseudomembranous trigonitis with voiding symptoms refractory to conservative therapy, laser coaulation of the trigonal lesion was not so satisfactory but may be one of therapeutic options. Further investigation is needed.

Comparison of Holmium Laser and Pneumatic Lithotripsy in Managing Ureteral Calculi:Report of 1035 Cases / 中国微创外科杂志

Objective To compare the efficacy of Holmium:YAG laser and pneumatic lithotripsy in the treatment of ureteral calculi.Methods From February 2002 to February 2007,totally 1035 patients with ureteral calculi underwent ureteroscopic lithotripsy with Holmium:YAG laser or pneumatic lithotripsy in our hospital.The data of the patients were analyzed retrospectively.Results The success rate of primary lithotripsy was 99.1%(328/331)in the patients received holmium laser,and 97.6%(687/704)in those who underwent pneumatic lithoclast(?2=2.703,P=0.100).Stone-free rate at 3 weeks was 98.2%(322/328)in the Holmium laser group,which was significantly higher than that in the pneumatic lithoclast group 88.1%(605/687),?2=28.639,P=0.000].However,significantly more ureteroscopes were damaged in the Holmium laser group than the pneumatic lithoclast group(11 vs 6,?2=8.509,P=0.004).Conclusions The stone-free rate in holmium laser group is higher than that in pneumatic lithoclast group.However,more ureteroscopes are damaged by holmium laser.

The Use of Holmium: Yag laser in Partial Menisectomy / 대한정형외과학회잡지

Previous applications of laser bone and cartilage ablation have focused largely on the CO2 and the Nd:Yag lasers, using both the continuous wave and rapid superpulsed mode, which revealed severe thermal damage such as tissue necrosis and carbonization of the remaining tissue. In contrast, Excimer lases have provided better histologic results with minimal or no thermal damage, but the ablation rate and cutting efficiency have remained unsatisfactory. Though arthroscopic partial menisectomy has become the accepted technique for dealing with tears in menisci, division of the meniscus is sometimes difficult in the confined joint space of the knee and is associated with iatrogenic injury to the articular cartilage. The ability to quickly and safely divide or remove meniscal tissue would be a distinct advantage. The Holmium:Yag laser has many potential advantages over the CO2 laster, the Nd:Yag laser and the Excimer laser. Its principal advantages include minimal mechanical trauma to the articular cartilage, greater access to tight or restricted area of the knee joint, and its ability to function in a saline medium and to resect meniscus with minimal tissue necrosis. We have evaluated the effectiveness of the Holmium:Yag laser 74 partial menisectomies of 57 patients. Among 74 meniscal tears, there were 35 medial and 39 lateral meniscal tears. The average operation time was 33 minutes in the menisectomy and hospital stay was average 3 days. There was no significant carbonization on the surrounding tissue. Menisectomy of the posterior horn was safe and easy and there was minimal iatrogenic articular cartilage damage.

The Effect of Holmium:YAG Laser Thermokeratoplasty on Corneal Astigmatism in Rabbits

This animal study was conducted to investigate the effect of holmium:YAG laser thermokeratoplasty on correction of hyperopic astigmatism. A pulsed holmium:YAG laser emitting a wavelength of 2.06 micrometer was used. Arcuate, reverse arcuate, linear patterns of laser burn were applied along the flat corneal meridian and their effects on the rabbit corneal curvature were studied. Keratometric measurements and cycloplegic refractive error were determined preoperatively, one, two, and three months after operation. The changes of refractive astigmatism in three patterns of laser burn were 0.8130, 3.0243, 0.8437 diopter, respectively, compared to that of the control group on postoperative three months. The changes of keratometric astigmatism were 1.1719, 3.0737, 0.7812 diopter, respectively, compared to that of the control group on postoperative three months. We found that holmium:YAG laser thermokeratoplasty is effective in steepening flat corneal meridian, and the most effective pattern is reverse arcuate type. In future holmium:YAG laser thermokeratoplasty might be clinically applicable as a operation of hyperopic astigmatism correction.