The holmium laser in urology.
OBJECTIVE
To review the physics related to the holmium laser, its laser-tissue interactions, and its application to the treatment of urological diseases.


BACKGROUND
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 and ureteral strictures; ablation of superficial transitional cell carcinoma; bladder neck incision and prostate resection; and lithotripsy of urinary calculi.


CONCLUSIONS
The holmium: YAG laser is a multi-purpose, multi-specialty surgical laser. It has been shown to be safe and effective for multiple soft tissue applications and stone fragmentation. Its utilization in urology is anticipated to increase with time as a result of these features.
Wollin
T A
TA
Division of Urology, University of Western Ontario, London, Canada.
Denstedt
J D
JD
D002245:Carbon Dioxide; D006695:Holmium; D006801:Humans; D053685:Laser Therapy / Q000295:instrumentation*; D017602:Lithotripsy, Laser / Q000295:instrumentation; D009354:Neodymium; D055585:Physical Phenomena; D010825:Physics; D013520:Urologic Surgical Procedures / Q000295:instrumentation*
D002245:Carbon Dioxide; D009354:Neodymium; D006695:Holmium