Holmium:YAG laser in the treatment of ureteral strictures

Rajiv K. Singal; Hassan A. Razvi; Samuel S. Chun M.D.; John D. Denstedt M.D.; Jack L. Sales M.D.

doi:10.1117/12.240030

17 May 1996 Holmium:YAG laser in the treatment of ureteral strictures

Rajiv K. Singal, Hassan A. Razvi, Samuel S. Chun M.D., John D. Denstedt M.D., Jack L. Sales M.D.

Proceedings Volume 2671, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems VI; (1996) https://doi.org/10.1117/12.240030
Event: Photonics West '96, 1996, San Jose, CA, United States

Abstract

Endourologic intervention has become widely considered the initial procedure of choice for short segment ureteral strictures. Techniques employed in conjunction with endourologic access to manage the strictured area have included balloon dilation, cold knife and electrosurgical incision. More recently laser incision with the potassium titanyl phosphate (KTP) laser has been employed. The holmium:YAG laser with a wavelength of 2100 nm has recently become available for urologic use. This wavelength is able to precisely vaporize and incise tissue. In this presentation we describe our results with holmium:YAG laser incision of ureteral strictures. Seventeen patients were treated including 12 patients with distal ureteral strictures, 4 patients with ureteroileal anastomotic strictures and 1 patient with a stricture in the ureter of a transplanted kidney. The holmium:YAG laser was employed using a 400 (mu) end-firing quartz fiber placed in contact with the tissue. Clinical and radiologic follow-up of at least 3 months post-surgery (range 3 - 21 months) is available in 14 patients. At last follow-up in these patients, 10/14 (71%) of strictures have remained open. While the ultimate success of endourological techniques of stricture management are determined by the inherent nature of the stricture rather than the technique employed, the holmium:YAG laser for endoureterotomy demonstrates short term efficacy and safety comparable to that reported for other minimally- invasive techniques of stricture management.

Citation Download Citation

Rajiv K. Singal, Hassan A. Razvi, Samuel S. Chun M.D., John D. Denstedt M.D., and Jack L. Sales M.D. "Holmium:YAG laser in the treatment of ureteral strictures", Proc. SPIE 2671, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems VI, (17 May 1996); https://doi.org/10.1117/12.240030

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