High Energy Pulsed Dye Laser Lithotripsy: Management of Ureteral Calcium Oxalate Monohydrate Calculi

Abstract

High energy pulsed dye laser lithotripsy (Candela MDL-2000), with energy output upgraded to a maximum of 140 mJ. at the laser fiber tip using the 320 mu core fiber, was compared to the initially commercialized device, with the energy output fixed at 60 mJ. using the 200 mu core fiber (Candela MDL-1). A total of 31 treatments in 28 patients was performed with the Candela MDL-1 device. Complete disintegration or at least fragmentation to spontaneously passable fragments occurred in 18 of 31 cases (58%). Only in 11 of the 24 calcium oxalate monohydrate calculi (46%) was fragmentation achieved. Another 73 laser lithotripsies in 72 patients were performed with the Candela MDL-2000 device. Complete disintegration or at least fragmentation to spontaneously passable fragments was achieved in 67 of 73 treatments (92%). Calcium oxalate monohydrate calculi were successfully treated in 41 of 45 procedures (91%). There was no response to the laser treatment in the only cystine calculus.