Techniques of Laser Lithotripsy

  • Stephen P. Dretler


A tunable pulsed dye laser has been used for the treatment of 157 patients with renal and ureteral calculi. All calculi treated were too large to be extracted by ureteroscopy or were not appropriate candidates for ESWL. In 106 cases, the stone was completely fragmented with the laser. The laser was used in combination with ESWL in 34 cases. In ten cases the laser had no action on the calculus. There were three instances of machine failure. The first two patients in the series developed ureteral strictures well below the level of laser action. One required operative repair. A newly developed 7.2 Fr. semi-rigid ureteroscope has enhanced the use of the laser. The current uses of laser include lower ureteral stones, calculi in the upper ureter unable to be treated by ESWL, stones in narrow ureter unable to be traversed by larger ureteroscopes, steinstrasse, for disimpaction of UPJ stones, and for percutaneous treatment of renal calculi via the flexible nephroscope.


Laser Fiber Shock Wave Lithotripsy Ureteral Calculus Ureteral Catheter Laser Lithotripsy 
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  1. 1.
    Dretler SP, Watson G, Parrish JA, et al: Pulsed dye laser fragmentation of ureteral calculi: initial clinical experience. J Urol 137: 386, 1987.PubMedGoogle Scholar
  2. 2.
    Watson G, Murray S, Dretler SP, et al: The pulsed dye laser for fragmenting urinary calculi. J Urol 138: 195, 1987.PubMedGoogle Scholar
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    Dretler SP: Laser photofragmentation of ureteral calculi: analysis of 75 cases. J Endourol 1: 9, 1987.CrossRefGoogle Scholar
  4. 4.
    Graff J, Diederichs W, Schultze H: Long-term follow-up in 1,003 extracorporeal shock wave lithotripsy patients. J Urol in press.Google Scholar

Copyright information

© Springer Science+Business Media New York 1988

Authors and Affiliations

  • Stephen P. Dretler
    • 1
  1. 1.Department of UrologyMassachusetts General Hospital and Harvard Medical SchoolBostonUSA

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