Retrograde Holmium:YAG Laser Disintegration of Stones in Pelvic Ectopic Kidneys: Would It Minimize the Risk of Surgery?

摘要

Purpose: To study the safety and efficacy of the holmium:YAG laser for disintegration of stones in pelvic ectopicnkidneys.nPatients and Methods: Between October 2005 and October 2006 four consecutive patients with large obstructingncalculi (u00023 cm in diameter) in the pelves of pelvic ectopic kidneys were prepared to be treated usingnretrograde ureterorenoscopy and holmium:YAG laser lithotripsy. All the patients were investigated withnx-rays of the kidney, ureters, and bladder (KUB) and intravenous urography (IVU). Holmium:YAG lasernlithotripsy was performed in a retrograde manner using energy ranging from 1 to 1.5 J/pulse with a frequencynranging from 15 to 20 Hz.nResults: Four patients were included in the study. The average age of the patients was 44 years (range 35–56nyears). The average operative time for the laser lithotripsy procedure was 120 minutes (range 100–180 minutes).nThree of the patients (75%) were rendered stone-free at 3 months. None of the patients developed backpressurenchanges, gross hematuria, or abdominal pain during the follow-up period. One of the patients couldnnot be treated endoscopically and required open surgery. Hospital stay ranged between 2 and 3 days.nConclusion: Retrograde ureteroscopy and holmium:YAG laser lithotripsy is efficacious for managing patientsnwith stones in pelvic kidneys. The procedure is safe and effective and avoids the complications of open surgery.