Subject(s)
Evidence-Based Medicine , Prostatic Hyperplasia/therapy , Adrenergic alpha-Antagonists/therapeutic use , Aged , Algorithms , Controlled Clinical Trials as Topic , Diagnosis, Differential , Enzyme Inhibitors/therapeutic use , Humans , Male , Phytotherapy , Prostate-Specific Antigen/blood , Prostatectomy , Prostatic Hyperplasia/diagnosis , Prostatic Hyperplasia/drug therapy , Prostatic Neoplasms/diagnosis , Randomized Controlled Trials as TopicABSTRACT
The Alexandrite laser system has proven to be an effective and safe method of ureteral lithotripsy. Some authors have recently reported the risk of interspersion of fiber splinters into tissue during lithotripsy, when short pulses and high power densities are employed. In vitro lithotripsy on renal calculi artificially placed in human ureters was realized under the parameters of a manufactured model (Alexantriptor, HMT). We have observed neither interspersion of fragments nor ureteral damage. These in vitro experiments and our clinical experience confirm that Alexandrite laser lithotripsy is reliable and safe.
Subject(s)
Lithotripsy , Ureter/pathology , Humans , In Vitro TechniquesABSTRACT
The alexandrite laser system has proven to be an effective and safe method of treating ureteral stones. When the electromagnetic energy of a laser light pulse is selectively absorbed by the stone, a plasma forms at the surface. This plasma, which is composed of ions and electrons, continues to absorb laser energy, reaching very high pressure and generating a shock wave that fragments the stone. The degree of stone fragmentation is directly related to the composition and crystal lattice structure of the calculus. 112 calculi have been treated, and laser lithotripsy was successful in 87.5%. 6% of the stones were inadvertently flushed back into the kidney. No patient required an open ureterolithotomy. Guidance of the laser fiber onto the stone was performed by rigid ureteroscopy. There were no troublesome complications, and in a 3-month follow-up, no sequelae were reported.
