Retrograde endoureteropyelotomy with the holmium:YAG laser. Initial experience.
OBJECTIVE
To evaluate the safety and efficacy of the holmium:YAG laser in the management of pelviureteric junction (PUJ) obstruction.


METHODS
Between November 1994 and February 1996, 8 patients with 5 primary and 3 secondary PUJ obstructions underwent retrograde ureteroscopic holmium:YAG laser endopyelotomy. A 320- to 365-micron (Slimline, Coherent) fibre was used to deliver the laser energy. A posterolateral endopyelotomy was performed under visual monitoring. All patients had a ureteral stent left in place postoperatively for 6 weeks and a renogram was performed after 3 months. The mean follow-up was 12.4 months (3-24 months).


RESULTS
Almost bloodless, accurate and layered division of the PUJ was easily performed. The average procedure time was 37.5 min. Our overall success rate was 87.5%.


CONCLUSIONS
The holmium:YAG laser is a safe, reliable laser with adequate coagulative properties and precise cutting abilities. This allows a 'bloodless' operative field for controlled, accurate and safe endoscopic division of the PUJ.
Biyani
C S
CS
Countess of Chester Hospital, UK.
Cornford
P A
PA
Powell
C S
CS
D000328:Adult; D005260:Female; D005500:Follow-Up Studies; D006695:Holmium; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D011866:Radioisotope Renography; D015607:Stents; D014517:Ureteral Obstruction / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*
D006695:Holmium