Retrograde holmium:YAG laser disintegration of stones in pelvic ectopic kidneys: would it minimize the risk of surgery?
OBJECTIVE
To study the safety and efficacy of the holmium:YAG laser for disintegration of stones in pelvic ectopic kidneys.


METHODS
Between October 2005 and October 2006 four consecutive patients with large obstructing calculi (>3 cm in diameter) in the pelves of pelvic ectopic kidneys were prepared to be treated using retrograde ureterorenoscopy and holmium:YAG laser lithotripsy. All the patients were investigated with x-rays of the kidney, ureters, and bladder (KUB) and intravenous urography (IVU). Holmium:YAG laser lithotripsy was performed in a retrograde manner using energy ranging from 1 to 1.5 J/pulse with a frequency ranging from 15 to 20 Hz.


RESULTS
Four patients were included in the study. The average age of the patients was 44 years (range 35-56 years). The average operative time for the laser lithotripsy procedure was 120 minutes (range 100-180 minutes). Three of the patients (75%) were rendered stone-free at 3 months. None of the patients developed back-pressure changes, gross hematuria, or abdominal pain during the follow-up period. One of the patients could not be treated endoscopically and required open surgery. Hospital stay ranged between 2 and 3 days.


CONCLUSIONS
Retrograde ureteroscopy and holmium:YAG laser lithotripsy is efficacious for managing patients with stones in pelvic kidneys. The procedure is safe and effective and avoids the complications of open surgery.
Fayad
Amr Salah Eldin
AS
Urology, Cairo University, Kasr El-Aini Hospital, Cairo, Egypt. amffayad@yahoo.com
D000328:Adult; D005260:Female; D006801:Humans; D007668:Kidney / Q000002:abnormalities* / Q000000981:diagnostic imaging; D007669:Kidney Calculi / Q000628:therapy*; D053844:Lasers, Solid-State; D007902:Length of Stay; D017602:Lithotripsy, Laser / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016896:Treatment Outcome; D018666:Ureteroscopy; D014567:Urography