Abstract: We used the holmium:YAG (Ho:YAG) laser successfully to fragment human urinary calculi of various sizes and compositions. At an energy level of 0.5 J/pulse and a frequency of 5 Hz, lithotripsy resulted in minimal ureteral-wall injury that was limited to superficial coagulative necrosis of the submucosa. Increasing the amount of energy or the frequency level, however, often resulted in significant damage to deeper ureteral tissue. When performed at low power settings with care to avoid direct ureteral-wall contact, Ho:YAG laser lithotripsy is safe and effective. !11
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