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The holmium:YAG laser was used successfully to fragment human urinary stones of various sizes and compositions. At an energy level of 0.5 J/pulse and at a frequency of 5 Hz, lithotripsy resulted in minimal ureteral wall injury. However, increasing the amount of energy or frequency level often caused significant damage to surrounding tissue. We conclude, therefore, that when used at low power settings with care to avoid direct ureteral wall contact, holmium:YAG laser lithotripsy appears to be an effective procedure. Additional studies are necessary to accurately assess its clinical safety.
Sayer et al. (Thu,) studied this question.