Research and Reports in Urology (May 2024)
Do Stone Characteristics and Laser Fiber Size Affect Ho: YAG Laser Time and Energy During Ureteroscopy?
Abstract
Abdihamid Hassan Hilowle,1 Abdikarim Hussein Mohamed2 1Urology Department, Mogadishu Urological Center, Mogadishu, Somalia; 2Urology Department, University of Somalia, Mogadishu, SomaliaCorrespondence: Abdikarim Hussein Mohamed, Tel + 252615167182, Email [email protected]: To assess the correlation of attenuation value measured as HU in Non-contrast computed tomography, stone size, location, fibre size and stone composition with Holmium: yttrium-aluminium garnet (Ho: YAG) laser parameters including, cumulative laser energy and final laser time.Materials and Methods: We prospectively analyzed 118 patients undergoing flexible/semirigid ureteroscopy and Holmium: YAG laser lithotripsy from October 2022 to October 2023 at Mogadishu Urological Centre. Our study parameters encompass preoperative stone characteristics determined in NCCT (stone size, attenuation value, and stone location), fibre size, cumulative laser energy and time, overall operative time, and postoperative stone composition analysis.Results: There were 118 patients eligible for our prospective study. In the logistic regression model for retrograde intrarenal surgery with a fibre size of 272 μm, cumulative laser energy showed a significant difference among stone size, location, fibre size, and calcium oxalate stones (P > 0.05). However, no significant difference was noticed in the attenuation value (P = 0.078) (R2 = 0.053). Our analysis showed a positive significance among all the parameters (P 0.05). For laser time, our analysis showed a positive significance among all parameters except the calcium oxalate stones, which showed no significant difference (P > 0.05).Conclusion: Our study showed that stone location, hardness, and fibre size are the most critical factors influencing the outcome of Ho: YAG laser parameters. The study revealed that CaOMH stones require more time to disintegrate into smaller ones, while PH-dependent stones such as carbonate apatite may require less time to fragment.Keywords: stone size, attenuation, stone density, Ho: YAG laser, cumulative laser energy
