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Holmium:YAG lithotripsy efficiency varies with energy density.
J Urol. 1998 Aug; 160(2):471-6.JU

Abstract

PURPOSE

We test the hypothesis that holmium:YAG lithotripsy efficiency varies with optical fiber size and energy settings (energy density).

MATERIALS AND METHODS

The 272, 365, 550 and 940 microm. optical fibers delivered 1 kJ. total holmium:YAG energy to calcium oxalate monohydrate calculi at energy output/pulse of 0.2 to 1.5 J. Stone mass loss was measured for each fiber energy setting. Stone crater width was characterized for single energy pulses. Fiber energy outputs were compared before and after lithotripsy.

RESULTS

Stone mass loss correlated inversely with optical fiber diameter (p <0.05). Stone loss correlated with energy/pulse for the 365, 550 and 940 microm. fibers (p <0.001). The 272 and 365 microm. fibers yielded equivalent stone loss at 0.2 and 0.5 J. per pulse. At energies of 1.0 J. per pulse or greater the 272 microm. optical fiber was prone to damage, and yielded reduced energy output and stone loss compared to the 365 microm. fiber (p <0.01). Stone crater width for single pulse energies correlated with energy settings for all fibers (p <0.001).

CONCLUSIONS

Lithotripsy efficiency with the holmium:YAG laser depends on pulse energy output and diameter of the optical delivery fiber, implying that lithotripsy efficiency correlates with energy density. The 365 microm. fiber is indicated for most lithotripsy applications. The 272 microm. fiber is susceptible to damage and inefficient energy transmission at energies of 1.0 J. per pulse or greater. The 272 microm. fiber is indicated at energies of less than 1.0 J. per pulse for small caliber ureteroscopes or when maximal flexible ureteroscope deflection is required.

Authors+Show Affiliations

Department of Ophthalmology, University of Texas Health Science Center, San Antonio, USA.No affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, Non-P.H.S.

Language

eng

PubMed ID

9679900

Citation

Vassar, G J., et al. "Holmium:YAG Lithotripsy Efficiency Varies With Energy Density." The Journal of Urology, vol. 160, no. 2, 1998, pp. 471-6.
Vassar GJ, Teichman JM, Glickman RD. Holmium:YAG lithotripsy efficiency varies with energy density. J Urol. 1998;160(2):471-6.
Vassar, G. J., Teichman, J. M., & Glickman, R. D. (1998). Holmium:YAG lithotripsy efficiency varies with energy density. The Journal of Urology, 160(2), 471-6.
Vassar GJ, Teichman JM, Glickman RD. Holmium:YAG Lithotripsy Efficiency Varies With Energy Density. J Urol. 1998;160(2):471-6. PubMed PMID: 9679900.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Holmium:YAG lithotripsy efficiency varies with energy density. AU - Vassar,G J, AU - Teichman,J M, AU - Glickman,R D, PY - 1998/7/29/pubmed PY - 1998/7/29/medline PY - 1998/7/29/entrez SP - 471 EP - 6 JF - The Journal of urology JO - J. Urol. VL - 160 IS - 2 N2 - PURPOSE: We test the hypothesis that holmium:YAG lithotripsy efficiency varies with optical fiber size and energy settings (energy density). MATERIALS AND METHODS: The 272, 365, 550 and 940 microm. optical fibers delivered 1 kJ. total holmium:YAG energy to calcium oxalate monohydrate calculi at energy output/pulse of 0.2 to 1.5 J. Stone mass loss was measured for each fiber energy setting. Stone crater width was characterized for single energy pulses. Fiber energy outputs were compared before and after lithotripsy. RESULTS: Stone mass loss correlated inversely with optical fiber diameter (p <0.05). Stone loss correlated with energy/pulse for the 365, 550 and 940 microm. fibers (p <0.001). The 272 and 365 microm. fibers yielded equivalent stone loss at 0.2 and 0.5 J. per pulse. At energies of 1.0 J. per pulse or greater the 272 microm. optical fiber was prone to damage, and yielded reduced energy output and stone loss compared to the 365 microm. fiber (p <0.01). Stone crater width for single pulse energies correlated with energy settings for all fibers (p <0.001). CONCLUSIONS: Lithotripsy efficiency with the holmium:YAG laser depends on pulse energy output and diameter of the optical delivery fiber, implying that lithotripsy efficiency correlates with energy density. The 365 microm. fiber is indicated for most lithotripsy applications. The 272 microm. fiber is susceptible to damage and inefficient energy transmission at energies of 1.0 J. per pulse or greater. The 272 microm. fiber is indicated at energies of less than 1.0 J. per pulse for small caliber ureteroscopes or when maximal flexible ureteroscope deflection is required. SN - 0022-5347 UR - https://www.unboundmedicine.com/medline/citation/9679900/Holmium:YAG_lithotripsy_efficiency_varies_with_energy_density_ L2 - https://www.jurology.com/doi/full/10.1016/s0022-5347(01)62927-6?url_ver=Z39.88-2003&amp;rfr_id=ori:rid:crossref.org&amp;rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -