Star Wars in Urology: Laser Treatment for Stones

When I talk about laser surgery for urine stones, many of my patients had imagined that I would draw out a laser device and point at the stone from a distance before firing and shattering it. Just like a chapter out of Star Wars the movie!
In actual fact, urologist use a Holmium Laser which works by contact with a stone. The laser energy is transmitted via a fibre optic cable which is inserted in to a scope device. The scope device is passed through the urine opening in to the bladder and the rest of the urine tube.



The laser fragments and vapourizes the stone very accurately as seen in the video above. No stones are too hard to fragment for the laser. It also causes minimal collateral damage to the surrounding tissue.

Urinary stones can be more painful than childbirth

Urinary stones are one of the commonest conditions that I would need to deal with as a urologist. Just a couple of days ago, my patient was brought to the hospital by an ambulance for severe right sided abdominal pain. He claimed that it was more painful than childbirth (although he does not have a personal experience). He also experienced abdominal cramps, nausea and vomiting. Urine tests showed blood in the urine. An urgent CT Scan revealed a stone in the right lower ureter (red arrow in photo) causing obstruction to the flow of urine from the right kidney. Although the stone was not very big (only 8mm in diameter) but the pain was excruciating because of the sudden obstruction that was associated with the stone.

He was treated with an urgent surgical procedure call ureteroscopy and laser lithotripsy. The procedure was performed under general anaesthesia. A fine and long tube with an in-built camera was inserted via the urine passage opening and followed in to the bladder and ureter. The stone was seen and laser was used to fragment the stone in to small pieces which were removed through the same tube. The whole procedure took less than half an hour and he was discharged on the same day. As the procedure did not involve any 'cut' to the body, he was able to return to work 48 hours later.