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EAU 2019

EAU 2019: Prospective Randomized Study of Fixed Laser Settings vs. Variable Laser Settings for a Better Stone Free Rate

Barcelona, Spain (UroToday.com) It is well known that retrograde intrarenal surgery is one of the most effective methods of treating kidney stones up to 2 cm. Laser lithotripsy is an effective modality for the management of renal and ureteral stones. However, at the moment there is no single protocol of lithotripsy laser settings. Authors conducted their own comparative study on two groups of patients with a single kidney stone to clarify this issue.

The study included a total of 113 patients who were randomly divided into two groups. Group A included a total of 58 patients and in this group, fixed laser settings were used at 1.0J energy and 12Hz frequency during the entire procedure. In Group B, with 55 patients, variable laser settings were used; initial fine fragmentation was performed @ 1.0J X 12Hz. Once the residual stone reduced enough to wobble, the energy was reduced to 6 W.  The authors have identified the name of this technique as a systematic dynamic painting technique. Settings were further reduced to 2.5W as required to complete the fragmentation process with minimal retropulsion.

Authors reported that stone-free rate (SFR) is in favor of systematic stone dusting with variable frequency (95.8% vs 83.6%, p = 0.055), especially in stones larger than 15 mm (80% vs 57.7% p = 0.03) with no statistically significant in postoperative complications between the groups.

Based on their results, the systematic dynamic painting technique (SFR - 95) solution even for hard solitary stones (10-20 mm) without increasing significant postoperative complications or hospital stay.


Presented by: Chandra Mohan Vaddi, Preeti Urology, and Kidney Hospital, Dept. of Urology, Hyderabad, India

Written by: Ali Stanislav Ph.D., MD, Fellow, Department of Urology, Sechenov University, Moscow, Russia, and Zhamshid Okhunov, MD, Twitter: @OkhunovZham, Department of Urology, the University of California-Irvine at the 34th European Association of Urology (EAU 2019) #EAU19, conference in Barcelona, Spain, March 15-19, 2019.