Urology

Why Holmium laser?

Holmium laser provides the best solution for Urology. Its wavelength is strongly absorbed by water, that’s why it is much better than the Nd:YAG laser to treat both stones and soft tissues. Lithotripsy using the holmium laser is characterized by a high success rate and low complication rate for all types of calculi.

The results of laser treatment can be superimposed if no larger than those provided by the traditional surgical methods, and compared to which however there is a net reduction in the operating morbility and hospitalisation time.

Applications

Indications:

• Calculosis of: Kidney, Ureter, Bladder
• Cervical-urethral obstructions in general
• Bladder neoplasias
• Neoplasias of the high renal excretory duct
• Congenital obstructions of the urinary tract junction
• Ureteral or urethral stenosis and srictures
• Low-grade renal neoplasias
• Condylomas and other viral lesions

Treatments of Calculosis

Conservative treatment
Diet, hydration, medications or a combination of these treatments may assist the physiological elimination of the calculi. The effectiveness of medications is dependent on the composition of the stone. The conservative treatment anyway, is successful only for stones smaller than 5mm in diameter.

Extracorporeal Shock Wave Lithotripsy (ESWL)
A lithotripter focus on the urinary stone the Shock waves that are generated outside of the body. The shock waves break the calculi into small pieces that are passed out of the body during urination. In 10-15% of cases is necessary to switch to endoscopic treatment or, rarely to open surgery. The elimination of the stone fragments sometimes needs long time, even months, due to the location and the dimension of the calculus. This elimination can determine painful reno-ureteral colics.

Percutaneous Nephrolithotomy (PCNL)
This method is often used for calculi larger than 2 centimeters in size or for hard stones. A nephroscope is passed directly into the kidney through a small incision is made in the back. Direct fragmentation of the stone is performed using an ultrasonic, electrohydraulic, or Holmium laser device through the nephroscope under direct vision. General anesthesia is required.

Endoscopic treatment
The endoscopic treatment, using Holmium laser lithotripsy, can also be performed using a specialized basket to remove the stone completely. The advantage of Holmium laser lithotripsy over others endoscopic treatments is decreased stone movement and decreased bleeding during treatment.

Open surgical treatment
Today, open surgical procedures on the kidney are rare. However, specific indications make open surgery necessary, these include the failure less invasive treatments due to size, composition and location of the stone and certain anatomic abnormalities of the urinary tract.