The Feasibility of Pop-Dusting Using High Power Laser (2J x 50Hz) in Retrograde Intrarenal Surgery for Renal Stones: Retrospective, Single-Center Experience.

OBJECTIVE Recently, retrograde intrarenal surgery (RIRS) using laser lithotripsy has become popular. However, the optimal laser energy setting for pop-dusting has not been established. In this study, we report our experiences of RIRS using the high power (up to 100 W) pop-dusting (HPPD) technique. METHODS This study retrospectively assessed 82 cases with RIRS using HPPD. Patients who underwent abdominal computed tomography (CT) or MAG3 diuretic renal scan at 3 months postoperatively were included in this study. Patient and stone characteristics and peri- and post-operative outcomes were evaluated. RESULTS The average number of renal stones was 3.67 ± 4.11, and the average length of the largest stones was 13.30 ± 6.41 mm. The mean Hounsfield units was 959.99 ± 384.73. The operation time was 58.10 ± 26.67 minutes. The mean HPPD time was 11.93 ± 9.48 minutes with settings of 1.97 ± 0.25J and 48.78 ± 3.29Hz. The stone-free rate was 89%. The mean hospital stay was 1.68 ± 1.29 days. Pelvocalyceal and ureter injuries were observed in 9.8% and 32.9% of the study population, respectively. However, there was no transfusion, subcapsular hematoma, persistent urinary leakage, ureteral or infundibular stricture, or renal functional deterioration. There was transient postoperative fever in 12.2% of the study population. CONCLUSIONS HPPD could be performed safely during RIRS for renal stones without significant complications such as collecting system injury or bleeding. High power laser mode (up to 100W) can be a safe and effective choice for pop-dusting during RIRS, especially for large and hard stones.