The development of a laser and a miniaturised ureteroscope system for ureteric stone management

The basic principles of laser fragmentation of calculi are discussed and the possible laser systems compared. A total of 250 patients were treated in our institution using a combination of a miniaturised ureteroscope, the MiniScope, and the pulsed-dye laser. The ureteric calculus (calculi) was fragmented and the ureter cleared in 246 patients. Failures were due to the inability to gain access to the ureteric orifice because of prostatomegaly (prostate, >100 g) in two cases and a ureteric stricture in two others. In five cases a second procedure was required despite clearing of the ureter at the time of surgery and despite the insertion of a double-J stent in the presence of residual calculi. No ureteric perforations or strictures resulted from treatment.