Dependence of water content in calculus phantom during Q-switched Tm:YAG laser lithotripsy

Q-switched Tm:YAG laser ablation mechanisms on urinary calculi are still unclear to researchers. In this study, dependence of water content in calculus phantom on calculus ablation performance was investigated. White gypsum cement was used as a calculus phantom model. The calculus phantoms were ablated at single pulse and contact mode in three different conditions: dry calculus in air, wet calculus in air, and wet calculus in water. Ablation volume was obtained on average 0.006, 0.008, and 0.008 mm 3 in dry calculus in air, wet calculus in air, and wet calculus in water groups, respectively. There were three proposed ablation mechanisms that could explain the effect of water content in calculus phantom on calculus ablation performance, including shock wave due to bubble collapse, spallation, and microexplosion. Shock wave generation due to bubble collapse in wet calculus in water condition had negligible effect on calculus ablation as captured by a needle hydrophone and cannot be a primary mechanism for calculus ablation in this study. Increased absorption coefficient of wet calculus can cause stronger spallation process compared with that caused by dry calculus; and as a result, higher calculus ablation was observed in both wet calculus in air and wet calculus in water. Vaporization of interstitial water in porous calculus phantom can also help enhance calculus ablation efficiency. There were some limitations in this study including use of small sample size and lack of employing real urinary calculus, which should be addressed in future experiment.