Holmium Laser Ureteroscopy

Ureteroscopy—an increasingly popular, alternative method to shock wave lithotripsy—is offered by Dr. Laub to remove or break up kidney stones that have become lodged in the ureter, or sometimes for stones still in the kidney.

A very narrow, lighted video imaging wand called a ureteroscope is passed up the urinary tract to the stone’s location. Smaller stones may be snared and removed whole with a basket device, while larger ones often need to be fragmented before removal (or in the case of patients with an exceptionally narrow ureteral diameter). Using a flexible Holmium laser fiber inserted through the scope, Dr. Laub targets the stones with powerful laser pulses that break them into tiny pieces (a process known as lithotripsy), which can then be removed.

In most cases following ureteroscopy, a tiny, hollow tube (stent) is positioned and left in the ureter temporarily to help drain urine and any remaining stones or fragments for the next several weeks.

Effectiveness and risks of Holmium Laser Ureteroscopy

With recent advances in the related technology, ureteroscopies now represent more than 25% of all kidney stone surgeries. Holmium laser ureteroscopy has been demonstrated to be very effective for multiple stones of all sizes, locations, and hardness, and to reduce complications from steinstrasse (ureter blockage from stone fragments), compared to shock wave lithotripsy.

Although Holmium laser ureteroscopy is minimally invasive and performed without an incision, general anesthesia and a hospital stay are required. Complications may include:

  • Localized pain from stent
  • Residual stone fragments
  • Ureteral injuries or stricture (rare)
  • Urinary issues
  • Blood in urine
  • Infection

Consult with Dr. Laub to discuss your best options for kidney stone treatment, and determine if Holmium laser ureteroscopy is the right decision for you.