Medscape is available in 5 Language Editions – Choose your Edition here.


Lasers in Urology Workup

  • Author: Michael Grasso, III, MD; Chief Editor: Bradley Fields Schwartz, DO, FACS  more...
Updated: Nov 25, 2015

Laboratory Studies

Laboratory studies are specific to treatment.


Imaging Studies

Imaging studies are specific to treatment.

Contributor Information and Disclosures

Michael Grasso, III, MD Professor and Vice Chairman, Department of Urology, New York Medical College; Director, Living Related Kidney Transplantation, Westchester Medical Center; Director of Endourology, Lenox Hill Hospital

Michael Grasso, III, MD is a member of the following medical societies: Medical Society of the State of New York, National Kidney Foundation, Society of Laparoendoscopic Surgeons, Societe Internationale d'Urologie (International Society of Urology), American Medical Association, American Urological Association, Endourological Society

Disclosure: Received consulting fee from Karl Storz Endoscopy for consulting.


David A Green, MD Staff Physician, Department of Urology, New York Medical College

Disclosure: Nothing to disclose.

Andrew Ira Fishman, MD Assistant Professor, Department of Urology, New York Medical College

Andrew Ira Fishman, MD is a member of the following medical societies: American Medical Association, American Urological Association

Disclosure: Nothing to disclose.

Eric J Moskowitz, MD, MBA Resident Physician, Department of Urology, New York Medical College

Eric J Moskowitz, MD, MBA is a member of the following medical societies: American Urological Association

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Mark Jeffrey Noble, MD Consulting Staff, Urologic Institute, Cleveland Clinic Foundation

Mark Jeffrey Noble, MD is a member of the following medical societies: American College of Surgeons, American Medical Association, American Urological Association, Kansas Medical Society, Sigma Xi, Society of University Urologists, SWOG

Disclosure: Nothing to disclose.

Chief Editor

Bradley Fields Schwartz, DO, FACS Professor of Urology, Director, Center for Laparoscopy and Endourology, Department of Surgery, Southern Illinois University School of Medicine

Bradley Fields Schwartz, DO, FACS is a member of the following medical societies: American College of Surgeons, Society of Laparoendoscopic Surgeons, Society of University Urologists, Association of Military Osteopathic Physicians and Surgeons, American Urological Association, Endourological Society

Disclosure: Nothing to disclose.

Additional Contributors

Raymond R Rackley, MD Professor of Surgery, Cleveland Clinic Lerner College of Medicine; Staff Physician, Center for Neurourology, Female Pelvic Health and Female Reconstructive Surgery, Glickman Urological Institute, Cleveland Clinic, Beachwood Family Health Center, and Willoughby Hills Family Health Center; Director, The Urothelial Biology Laboratory, Lerner Research Institute, Cleveland Clinic

Raymond R Rackley, MD is a member of the following medical societies: American Urological Association

Disclosure: Nothing to disclose.

  1. Gross AJ, Netsch C, Knipper S, Hölzel J, Bach T. Complications and early postoperative outcome in 1080 patients after thulium vapoenucleation of the prostate: results at a single institution. Eur Urol. 2013 May. 63(5):859-67. [Medline].

  2. Kronenberg P, Traxer O. Update on lasers in urology 2014: current assessment on holmium:yttrium-aluminum-garnet (Ho:YAG) laser lithotripter settings and laser fibers. World J Urol. 2015 Apr. 33 (4):463-9. [Medline].

  3. Iacono F, Prezioso D, Di Lauro G, Romeo G, Ruffo A, Illiano E, et al. Efficacy and safety profile of a novel technique, ThuLEP (Thulium laser enucleation of the prostate) for the treatment of benign prostate hypertrophy. Our experience on 148 patients. BMC Surg. 2012. 12 Suppl 1:S21. [Medline]. [Full Text].

  4. Yang Z, Wang X, Liu T. Thulium laser enucleation versus plasmakinetic resection of the prostate: a randomized prospective trial with 18-month follow-up. Urology. 2013 Feb. 81(2):396-400. [Medline].

  5. Lerner LB, Rajender A. Laser prostate enucleation techniques. Can J Urol. 2015 Oct. 22 (5 Suppl 1):53-9. [Medline].

  6. Marguet CG, Sung JC, Springhart WP, L'Esperance JO, Zhou S, Zhong P, et al. In vitro comparison of stone retropulsion and fragmentation of the frequency doubled, double pulse nd:yag laser and the holmium:yag laser. J Urol. 2005 May. 173(5):1797-800. [Medline].

  7. Dubosq F, Pasqui F, Girard F, Beley S, Lesaux N, Gattegno B, et al. Endoscopic lithotripsy and the FREDDY laser: initial experience. J Endourol. 2006 May. 20(5):296-9. [Medline].

  8. Fuh E, Haleblian GE, Norris RD, Albala WD, Simmons N, Zhong P, et al. The effect of frequency doubled double pulse Nd:YAG laser fiber proximity to the target stone on transient cavitation and acoustic emission. J Urol. 2007 Apr. 177(4):1542-5. [Medline].

  9. Malek RS, Kuntzman RS, Barrett DM. Photoselective potassium-titanyl-phosphate laser vaporization of the benign obstructive prostate: observations on long-term outcomes. J Urol. 2005 Oct. 174(4 Pt 1):1344-8. [Medline].

  10. Woo H, Reich O, Bachmann A, et al. Outcome of GreenLight HPS 120-W laser therapy in specific patient populations: those in retention, on anticoagulants, and with large prostates (≥80 mL). Eur Urol Suppl. 2008. 7:378-383.

  11. Jaeger CD, Krambeck AE. Holmium laser enucleation of the prostate for persistent lower urinary tract symptoms after prior benign prostatic hyperplasia surgery. Urology. 2013 May. 81(5):1025-9. [Medline].

  12. Mmeje CO, Nunez-Nateras R, Warner JN, Humphreys MR. Age-stratified outcomes of holmium laser enucleation of the prostate. BJU Int. 2013 Mar 19. [Medline].

  13. Gilling PJ, Kennett K, Westenberg AM et al. Relief of symptoms and obstruction following HoLEP and TURP size matters: a meta-analysis. J Endourol. 2005. 19 (Suppl. 1):

  14. Grasso M. Experience with the holmium laser as an endoscopic lithotrite. Urology. 1996 Aug. 48(2):199-206. [Medline].

  15. Sciarra A, Von Heland M, Minisola F, Salciccia S, Cattarino S, Gentile V. Thulium Laser Supported Nephron Sparing Surgery for Renal Cell Carcinoma. J Urol. 2013 Jan 29. [Medline].

  16. Thomas AZ, Smyth L, Hennessey D, O'Kelly F, Moran D, Lynch TH. Zero Ischemia Laparoscopic Partial Thulium Laser Nephrectomy. J Endourol. 2013 Mar 8. [Medline].

  17. Perkash I. Ablation of urethral strictures using contact chisel crystal firing neodymium:YAG laser. J Urol. 1997 Mar. 157(3):809-13. [Medline].

  18. Schneede P, Muschter R. [Laser applications in condylomata acuminata]. Urologe A. 1994 Jul. 33(4):299-302. [Medline].

  19. Windahl T, Andersson SO. Combined laser treatment for penile carcinoma: results after long-term followup. J Urol. 2003 Jun. 169(6):2118-21. [Medline].

  20. Koenig F, McGovern FJ, Althausen AF, Deutsch TF, Schomacker KT. Laser induced autofluorescence diagnosis of bladder cancer. J Urol. 1996 Nov. 156(5):1597-601. [Medline].

  21. Absten GT. Physics of light and lasers. Obstet Gynecol Clin North Am. 1991 Sep. 18(3):407-27. [Medline].

  22. Aho TF, Gilling PJ, Kennett KM, Westenberg AM, Fraundorfer MR, Frampton CM. Holmium laser bladder neck incision versus holmium enucleation of the prostate as outpatient procedures for prostates less than 40 grams: a randomized trial. J Urol. 2005 Jul. 174(1):210-4. [Medline].

  23. Bagley DH, Schultz E, Conlin MJ. Laser division of intraluminal sutures. J Endourol. 1998 Aug. 12(4):355-7. [Medline].

  24. Bhatta KM. Lasers in urology. Lasers Surg Med. 1995. 16(4):312-30. [Medline].

  25. Bradley D. Plastic Lasers Shine Brightly. Nature. 1996. 382:671.

  26. Chacko KN, Donovan JL, Abrams P, Peters TJ, Brookes ST, Thorpe AC, et al. Transurethral prostatic resection or laser therapy for men with acute urinary retention: the ClasP randomized trial. J Urol. 2001 Jul. 166(1):166-70; discussion 170-1. [Medline].

  27. Elzayat EA, Al-Mandil MS, Khalaf I, Elhilali MM. Holmium laser ablation of the prostate versus photoselective vaporization of prostate 60 cc or less: short-term results of a prospective randomized trial. J Urol. 2009 Jul. 182(1):133-8. [Medline].

  28. Floratos DL, de la Rosette JJ. Lasers in urology. BJU Int. 1999 Jul. 84(2):204-11. [Medline].

  29. Fried NM. Potential applications of the erbium:YAG laser in endourology. J Endourol. 2001 Nov. 15(9):889-94. [Medline].

  30. Fried NM, Murray KE. High-power thulium fiber laser ablation of urinary tissues at 1.94 microm. J Endourol. 2005 Jan-Feb. 19(1):25-31. [Medline].

  31. Gravas S, Bachmann A, Reich O, Roehrborn CG, Gilling PJ, De La Rosette J. Critical review of lasers in benign prostatic hyperplasia (BPH). BJU Int. 2011 Apr. 107(7):1030-43. [Medline].

  32. Grocela JA, Dretler SP. Intracorporeal lithotripsy. Instrumentation and development. Urol Clin North Am. 1997 Feb. 24(1):13-23. [Medline].

  33. Kabalin JN, Bite G, Doll S. Neodymium:YAG laser coagulation prostatectomy: 3 years of experience with 227 patients. J Urol. 1996 Jan. 155(1):181-5. [Medline].

  34. Keeley FX Jr, Bibbo M, Bagley DH. Ureteroscopic treatment and surveillance of upper urinary tract transitional cell carcinoma. J Urol. 1997 May. 157(5):1560-5. [Medline].

  35. Kollmorgen TA, Malek RS, Barrett DM. Laser prostatectomy: two and a half years' experience with aggressive multifocal therapy. Urology. 1996 Aug. 48(2):217-22. [Medline].

  36. Lobik L, Ravid A, Nissenkorn I, Kariv N, Bernheim J, Katzir A. Bladder welding in rats using controlled temperature CO2 laser system. J Urol. 1999 May. 161(5):1662-5. [Medline].

  37. Lynch DF Jr, Schellhammer PF. Laser Surgery in Penile Lesions. Walsh PC, ed. Campbell's Urology. 7th ed. Philadelphia, Pa: WB Saunders Co; 1998. 2467-8.

  38. Matin SF, Yost A, Streem SB. Ureteroscopic laser endopyelotomy: a single-center experience. J Endourol. 2003 Aug. 17(6):401-4. [Medline].

  39. McCullough DL. Minimally Invasive Treatment of Benign Prostatic Hyperplasia. Walsh PC, ed. Campbell's Urology. 7th ed. Philadelphia, Pa: WB Saunders Co; 1998. 1482-90.

  40. Montorsi F, Naspro R, Salonia A, et al. Holmium laser enucleation versus transurethral resection of the prostate: results from a 2-center, prospective, randomized trial in patients with obstructive benign prostatic hyperplasia. J Urol. 2004 Nov. 172(5 Pt 1):1926-9. [Medline].

  41. Narayan P, Tewari A, Aboseif S, Evans C. A randomized study comparing visual laser ablation and transurethral evaporation of prostate in the management of benign prostatic hyperplasia. J Urol. 1995 Dec. 154(6):2083-8. [Medline].

  42. Razvi HA, Denstedt JD, Chun SS, Sales JL. Intracorporeal lithotripsy with the holmium:YAG laser. J Urol. 1996 Sep. 156(3):912-4. [Medline].

  43. Reich O, Bachmann A, Schneede P, Zaak D, Sulser T, Hofstetter A. Experimental comparison of high power (80 W) potassium titanyl phosphate laser vaporization and transurethral resection of the prostate. J Urol. 2004 Jun. 171(6 Pt 1):2502-4. [Medline].

  44. Reich O, Bachmann A, Siebels M, Hofstetter A, Stief CG, Sulser T. High power (80 W) potassium-titanyl-phosphate laser vaporization of the prostate in 66 high risk patients. J Urol. 2005 Jan. 173(1):158-60. [Medline].

  45. Schatzl G, Madersbacher S, Lang T, Marberger M. The early postoperative morbidity of transurethral resection of the prostate and of 4 minimally invasive treatment alternatives. J Urol. 1997 Jul. 158(1):105-10; discussion 110-1. [Medline].

  46. Scherr DS, Poppas DP. Laser tissue welding. Urol Clin North Am. 1998 Feb. 25(1):123-35. [Medline].

  47. Smith JA, Bray WL. Commentary on the desired tissue effects for laser treatment of the prostate and how they can best be achieved?. J Urol. 1995 Jan. 153(1):2. [Medline].

  48. Stein BS, Kendall AR. Lasers in urology. I. Laser physics and safety. Urology. 1984 May. 23(5):405-10. [Medline].

  49. Stein BS, Kendall AR. Lasers in urology. II. Laser therapy. Urology. 1984 May. 23(5):411-6. [Medline].

  50. Syed HA, Biyani CS, Bryan N, Brough SJ, Powell CS. Holmium:YAG laser treatment of recurrent superficial bladder carcinoma: initial clinical experience. J Endourol. 2001 Aug. 15(6):625-7. [Medline].

  51. Tan A, Liao C, Mo Z, Cao Y. Meta-analysis of holmium laser enucleation versus transurethral resection of the prostate for symptomatic prostatic obstruction. Br J Surg. 2007 Oct. 94(10):1201-8. [Medline].

  52. Teichman JM, Chan KF, Cecconi PP, Corbin NS, Kamerer AD, Glickman RD, et al. Erbium: YAG versus holmium:YAG lithotripsy. J Urol. 2001 Mar. 165(3):876-9. [Medline].

  53. Teichman JM, Vassar GJ, Bishoff JT, Bellman GC. Holmium:YAG lithotripsy yields smaller fragments than lithoclast, pulsed dye laser or electrohydraulic lithotripsy. J Urol. 1998 Jan. 159(1):17-23. [Medline].

  54. Tooher R, Sutherland P, Costello A, Gilling P, Rees G, Maddern G. A systematic review of holmium laser prostatectomy for benign prostatic hyperplasia. J Urol. 2004 May. 171(5):1773-81. [Medline].

  55. Watterson JD, Sofer M, Wollin TA, Nott L, Denstedt JD. Holmium: YAG laser endoureterotomy for ureterointestinal strictures. J Urol. 2002 Apr. 167(4):1692-5. [Medline].

  56. Wen CC, Nakada SY. Energy ablative techniques for treatment of small renal tumors. Curr Opin Urol. 2006 Sep. 16(5):321-6. [Medline].

This is a central stone defect, which is the product of holmium:yttrium-aluminum-garnet (Ho:YAG) laser lithotripsy. This particular stone was composed of cysteine, which will not fragment with the pulsed dye laser. In addition, Ho:YAG produces sulfur dioxide gas when treating cysteine stones, producing a characteristic odor during treatment.
All material on this website is protected by copyright, Copyright © 1994-2016 by WebMD LLC. This website also contains material copyrighted by 3rd parties.