title: Retrograde holmium:YAG laser disintegration of stones in pelvic ectopic kidneys: would it minimize the risk of surgery?
abstract: 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.
authors: Urology, Cairo University, Kasr El-Aini Hospital, Cairo, Egypt. amffayad@yahoo.com
authors: Amr Salah Eldin
authors: AS
authors: Fayad
mesh_terms: 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