Comparative Experimental Study on the Disintegrating Effect of the Tunable Dye Laser and Ultrasound on Stones of Various Composition
Most ureteral stones are amenable to extracorporeal shock-wave lithotripsy (ESWL) therapy which as a non-invasive or, in conjunction with ureteral manipulation, a minimally-invasive procedure has become the treatment of first choice. Large, impacted stones which can not be manipulated are an indication for disintegration using direct-contact energy sources. For the past two years, we have been using a 2.5-Fr. wire ultrasound probe in conjunction with 10.5-Fr. and 12.5-Fr. rigid ureteroscopes (Storz). This enabled us to break up all stones, with few exceptions, where electrohydraulic energy became necessary. The potential danger of this procedure includes ureteral damage from the ureteroscopy and the probe. The most innovative method of breaking up ureteral stones is the tunable dye laser (Candela) which was introduced in September, 1986 at our institution as an investigational device. The 250- Laser fiber can be guided to the stone using small-caliber flexible ureteroscopes or steerable flexible ureterorenoscopes.
KeywordsLaser Fiber Ultrasound Probe Ureteral Stone Penrose Drain Impacted Stone
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