Cystoscopic holmium lithotripsy of large bladder calculi.

Patients with large bladder stones are often difficult to treat endoscopically with the current modalities available to the practicing urologist. We present the results of cystolithotripsy of bladder stones larger than 4 cm with the holmium: Yag (Ho:Yag) laser. In our three patients, all patients were rendered stone free without complication using the Ho:Yag laser, with an average anesthesia time of 50 min. Minimal tissue trauma or stone movement were observed. All stones were easily fragmented, even one stone that had previously been refractory to electrohydraulic lithotripsy. Our conclusion is that the Ho:Yag laser is a safe and effective treatment for patients with large bladder stones. Its use may make it possible to eradicate stones endoscopically that otherwise would require open surgery.