The Holmium Laser in Urology

ABSTRACT Objective: To review the physics related to the holmium laser, its laser-tissue interactions, and its application to the treatment of urological diseases. Summary and Background Data: The holmium: YAG laser is a solid-state, pulsed laser that emits light at 2100 nm. It combines the qualities of the carbon dioxide and neodymium: YAG lasers providing both tissue cutting and coagulation in a single device. Since the holmium wavelength can be transmitted down optical fibers, it is especially suited for endoscopic surgery. Methods: The authors provide a review of the literature as it relates to the holmium laser and its application to urology. Results: The holmium wavelength is strongly absorbed by water. Tissue ablation occurs superficially, providing for precise incision with a thermal injury zone ranging from 0.5 to 1.0 mm. This level of coagulation is sufficient for adequate hemostasis. The most common urologic applications of the holmium laser that have been reported include incision of urethral ...