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Background:
Holmium lasers have been used to treat bladder stones and achieve good therapeutic effects, but its efficacy remains to be explored.
Methods:
The PubMed, Embase, Medline, Ovid, Springer, and Web of Sciences databases were searched from their establishment to December 31, 2020. Studies of randomized control trials (RCTs) examining the...
Context in source publication
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Backgrounds
To compare the effectiveness and safety of high-power (100 W) vs. low-power (20 W) laser settings for transurethral laser lithotripsy in the treatment of urethral stones.
Methods
The trial was open to all patients scheduled for transurethral holmium laser lithotripsy who had urethral stones with the maximal diameter. Either the low-pow...
While employing the Holmium YAG laser, photonic technologies can help detect urinary stones and enhance safety for the patient. Our research group recently found that continuous monitoring of the fluorescence spectra of urinary calculi suffices to distinguish between stone, tissue, and endoscope components precisely and in real time. We hereby intr...
The single operator per oral cholangioscope is a catheter-based system that allows for direct visualization of the bile duct and pancreatic duct. The instrument with its improved imaging technique and larger accessory channel allows for high-quality image acquisition and performance of therapeutic and diagnostic procedures within the bile duct and...
Citations
... However, these complications can be alleviated by HoLEP, even in cases of antithrombotic therapy [21]. Holmium use for laser stone fragmentation seems to provide considerable advantages in shortening stone fragmentation time, postoperative complication rate, and recurrence rate compared to pneumatic lithotripsy [22]. Furthermore, lithotripsy combined with HoLEP does not appear to increase the risk of postoperative complications compared with HoLEP alone, regardless of stone size or composition [23,24]. ...
Purpose
To compare the postoperative outcomes of male patients who underwent bladder stone (BS) removal, with or without concomitant benign prostatic hyperplasia (BPH) surgery.
Patients and methods
All men aged > 50 years who underwent BS removal at two French university hospitals between 2009 and 2018 were retrospectively reviewed. Four binary outcome criteria were identified during the follow-up: early postoperative complications, stone recurrence, subsequent surgery for BS or BPH, and late surgical complications. A composite score ranging from 0 to 4 was calculated by combining the four criteria.
Results
A median follow-up period of 42 months was observed in 179 patients. Of these, 107 patients were in the “concomitant surgical treatment” (CST) group and 72 in the bladder “stone removal alone” (SRA) group. The CST group presented higher baseline post-void residual volume (105 vs. 30 ml, p = 0.005). Patients who underwent CST had a significantly lower rate of BS recurrence (12% vs. 39%; p = 0,001) and underwent fewer subsequent surgeries (14% vs. 44%; p < 0.001). There was no significant difference in the early (51% vs. 35%, p = 0,168) and late (26% vs. 17%, p = 0,229) complications rates between the two groups. A better composite score was observed in the CST than in the SRA, but the difference was not significant (3.07 vs. 2.72, p = 0.078).
Conclusion
As CST increases morbidity and decreases the risk of reoperation, each situation should be considered, taking into account patient choice and comorbidities.
... For vesical calculus, Holmium laser lithotripsy has significantly reduced the hospitalization time of patients and elevated the stone clearance rate [16]. ...
Lasers as a technology have a leading role in the modern urological treatment armamentarium. In this article, the application of lasers in different areas of urology is described. The major uses are in urolithiasis, benign prostatic enlargement (BPE), and management of many urological malignancies and other benign pathologies. Lasers have become an established treatment modality in urolithiasis, an acceptable alternative with the least side effect profile in BPE patients, and a novel and promising therapy in many other fields of Urology.
... ЧШНЛ швидко стала «золотим стандартом» лікування всіх каменів розміром понад 2 см і залишається стандартною процедурою при великих ниркових конкрементах. Доступні різні жорсткі та гнучкі ендоскопи, вибір яких здебільшого базується на рекомендаціях хірурга [37,38]. Процедуру виконують з використанням задньої чашечки зазвичай у верхньому або нижньому полюсі залежно від локалізації конкрементів та близькості прилеглих органів. ...
Urinary stone disease (USD) is the most common and progressive disease of the urinary system, which is characterized by frequent exacerbations and a severe course. This is a complex disease caused by various causes, in which several biochemical processes are involved, occurring not only in the urinary system, but also in the whole organism. USD depends on geographical, climatic, ethnic, dietary and genetic factors. Over the past 20 years there has been an increase prevalence of this disease. The course of USD is characterized by the acute and chronic pyelonephritis and frequent recurrence, which leads to the development of renal failure, disability and fatal consequences. Calculus can form de novo anywhere in the urinary tract. The pathophysiology of USD differs depending on the place of stone formation and depends on endogenous and exogenous factors. Urinary tract stones are classified depending on etiology, location, size, number, frequency of occurrence, and radiopacity. The main symptoms of USD are pain of various nature; microscopic hematuria; dysuria, which most often indicates the presence of a stone in the urinary bladder or a low location in the ureters; discharge of crystals of urinary salts or concretions; increased body temperature. The diagnosis of USD is based on a carefully history taking and physical examination, which allows to determine the correct direction of diagnostic approach, which include laboratory and instrumental methods of diagnosis. Ultrasound diagnosis is used as the main method for visualization of calculi, but recently non contrast-enhanced computed tomography has become the standard for the diagnosis of acute low back pain, replacing intravenous urography. The choice of treatment is based on many parameters, such as the number, size, morphology, shape, volume, mobility, hardness and location of the stones and is individualized for each patient. There are two main approaches: conservative treatment and surgic al one. Medicinal treatment of USD is used primarily to prevent the repeated formation of new stones or to increase those inclusions that are already present in the organs. Drug therapy is carried out with the aim of normalizing processes in the body, the failure of which leads to the development of pathology. However, conservative treatment has its limitations and is most often used as a symptomatic treatment. Open laparoscopic interventions are rarely used recently, minimally invasive methods are more popular: extracorporeal shock-wave lithotripsy; ureterorenoscopy; percutaneous nephrolithotomy. Taking into account the increase in the prevalence of USD in Ukraine and disability (the third place among the general spectrum of causes of disability in urological practice), the article analyzes and reviews modern approaches to classification, early and accurate diagnosis, and choosing a timely and correct method of treatment.
... It has been suggested that holmium could have an effect on the metabolic rate in humans (Lv et al. 2021). Additionally, Poniedziałek et al. looked at the possibility of the existence of holmium in human colostrum milk, which is produced during the initial phase of milk production in a nursing mother (Poniedziałek et al. 2017). ...
The introduction of bioactive glasses (BGs) precipitated a paradigm shift in the medical industry and opened the path for the development of contemporary regenerative medicine driven by biomaterials. This composition can bond to live bone and can induce osteogenesis by the release of physiologically active ions. 45S5 BG products have been transplanted effectively into millions of patients around the world, primarily to repair bone and dental defects. Over the years, many other BG compositions have been introduced as innovative biomaterials for repairing soft tissue and delivering drugs. When research first started, many of the accomplishments that have been made today were unimaginable. It appears that the true capacity of BGs has not yet been realized. Because of this, research involving BGs is extremely fascinating. However, to be successful, it requires interdisciplinary cooperation between physicians, glass chemists, and bioengineers. The present paper gives a picture of the existing clinical uses of BGs and illustrates key difficulties deserving to be faced in the future. The challenges range from the potential for BGs to be used in a wide variety of applications. We have high hopes that this paper will be of use to both novice researchers, who are just beginning their journey into the world of BGs, as well as seasoned scientists, in that it will promote conversation regarding potential additional investigation and lead to the discovery of innovative medical applications for BGs.
Objective
To evaluate the efficacy and safety of Holmium: Yttrium-Aluminum-Garnet (Ho:YAG) laser in bladder lithotripsy using high-power settings > 100 W.
Materials and Methods
A combined experimental and clinical study was conducted. The Quanta Cyber: Ho 150 with a 550 μm Quanta optical fiber was utilized in all set-ups. Ablation rates for soft and hard artificial stones were tested in vitro using 100 W and 20 W power settings. In the experiment, a porcine bladder was used. The optical fiber was inserted through a rigid cystoscope, whilst a K-type thermocouple was inserted in the bladder dome. The tested high-power settings were 152 W, 120 W and 105 W. In every trial, the lasing time was over 60 s. In the clinical study, 35 patients underwent transurethral high-power bladder lithotripsy. Laser settings were set between 100 W and 150 W.
Results
Stone mass (stone weight) was significantly lower after stone ablation independently of the stone type or the laser settings. Significantly higher mass decrease and ablation rate were detected in high-power compared to low-power settings. In the experiment, the highest temperature recorded was 32°C at 152 W. At 120 W and 105 W, the peak temperatures didn’t reach 30°C. In the clinical study, a stone-free rate of 100% and a mean operative time of 43 ± 18 min were reported. All patients stayed in the hospital for one day except for one who presented minor hematuria. Additional complications did not occur.
Conclusion
Ho:YAG laser lithotripsy > 100 W is an effective, fast and safe modality for the treatment of bladder calculi.
The prevalence of bladder stones is quite high, which represents a significant medical and social problem. Despite significant progress in the field of medicine, there are currently no generally accepted standards for the treatment of patients with cystolithiasis. This review presents an analysis of literature sources using the PubMed, Google Scholar, Scopus, eLibrary, Cyberleninka databases, dedicated to modern aspects of the treatment of patients with bladder stones and bladder outlet obstruction. The features, advantages and disadvantages of various surgical methods for treating such patients are described in detail. It has been shown that despite the fact that transurethral cystolithotripsy with litholapaxy is the most common surgical option, modern medicine offers alternative methods of surgical treatment. It is emphasized that to achieve the greatest effectiveness of treatment, the correct choice of surgical method is necessary, based on the individual characteristics of the patient. It was noted that there is a need to optimize the treatment algorithm for patients with bladder stones and bladder outlet obstruction.
