[Endoscopic treatment of pielo-uretheral lithiasis with Holmium-YAG laser. Two years of experience].

OBJECTIVE To show the efficiency and safety of Holmium laser in the treatment of pyeloureteral lithiasis, based on our own experience since the introduction of this source of energy in our department. MATERIAL AND METHODS From January 2002 to February 2004, we have carried out 198 ureterorenoscopies using Holmium laser to treat lithiasis located in the upper urinary tract. In all cases, a previous radiological study demonstrated the stone. Follow-up, where the efficacy of the treatment was assessed, was done with a scout x-ray after 3-4 weeks. We evaluated the localization and features of the lithiasis, technical aspects, results and complications of our series. RESULTS The most common localization of the lithiasis was the pelvic ureter (59%), with the number of treated cases in both the iliac and lumbar ureter being similar (16%). 70% of the lithiasis had a size between 0.5 and 1.5 cm, and 15% showed a diameter bigger than 1.5 cm. In 61.8% of cases, laser lithotripsy was carried out under spinal anaesthesia, being the average of the pulses used 2532 (confidence interval 95%), using a working power of 1 J in all cases. The overall efficacy of the procedure in terms of size and localization was 95.5%. The complication rate was scarce (2.19%). CONCLUSIONS Holmium laser lithotripsy is a very effective and safe procedure since in our experience it is 95.5% efficient for pyeloureteral lithiasis treatment and has a low rate of complications.