Laser Lithotripsy: Further Experience with Nd:YAG Laser

Fifteen patients with ureteral stones underwent attempted laser-induced shock wave lithotripsy. Shock waves were generated by a pulsed Q-switched NdrYAG laser (8-12-nsec pulses, 1064-nm wavelength). The transmission system consisted of a 600-μm fiber mounted with a newly developed optomechanical coupler. Complete fragmentation of the stones occurred in 11 patients. Partial fragmentation occurred in three patients, and in one patient, the laser failed to fragment the stone. Laser lithotripsy succeeded in four patients using only fluoroscopic control without ureteroscopy. In a trial to optimize the technique, we report our initial experience with the new transmission system.