An Experimental Study on Ureteral Tissue Damage with Technomed Pulsolith Laser Irradiation in Human in Vitro / 대한비뇨기과학회지

The pulsed dye laser(Technomed pulsolith) with a wave-length of 504nm was irradiated directly in vitro on four human ureters which were obtained by ureteronephrectomy. The irradiation was at 5Hz with a pulse energy of 40 to 100mJ and total pulse count of 200 to 1000. Immediately after irradiation, the ureteral tissues were fixed with formalin solution and H&E stain. The extent of tissue damage was examined with light microscope. In this experimental study, we observed that mucosal damage occurred from pulse energy of 60mJ, total pulse rate of 600 and submucosal damage occurred from pulse energy of 80mJ, total pulse rate of 800. But We believed that the pulsed dye laser was safe because most stones were fragmented at less than a pulse energy of 80mJ, a total pulse rate of 800, and the ureter was irradiated indirectly during laser lithotripsy.

Initial experience of ureteral laser lithotripsy using the technomed pulsolith / 대한비뇨기과학회지

From January 1992 to January 1993, 45 patients with calculi ranging in size from 5x4mm to 22 x 17mm underwent lithotripsy with a new pulsed dye laser (Technomed Pulsolith) under the ureteroscope. The results were obtained as follows; 1. The success rates according to location were 60% (3/5) in upper ureter, 63% (7/11) in mid ureter and 93% (27/29) in lower ureter. The mean success rate was 82% (37/45). 2. The success rates according to stone size were 100% (4/4) in below 5mm, 77% (10/13) in 6 to 10mm and 82% (23/28) in above 10mm. 3. The total number of failure was eight. That occurred due to various. The causes of failure were the poor visualization in five cases, the laser resistant calcium oxalate stones in two cases and the upward migration in one case. Six cases of failure were resolved in spontaneous passing, and two cases were managed by ureterolithotomy. 4. Complications were showed in 17 cases that was gross hematuria in 12 cases (26.6%) and ureteral perforation in 5 cases (11.1%). However, no surgical intervention was needed in all cases. We conclude that laser lithotripsy with Technomed Pulsolith was considered to be effective and safe procedure for the treatment of lower ureteral calculi.