Laser Lithotripsy — Laser Treatment for Kidney Stones
Laser lithotripsy, most commonly using a Holmium laser, is a minimally invasive procedure to break kidney and ureteric stones into dust or small fragments that can be passed or extracted. A thin ureteroscope is passed through the urethra into the bladder and up the ureter to the stone. The laser fibre delivers energy to fragment the stone with precision, making it one of the most effective treatments for ureteric stones and moderate-sized kidney stones.
How Does Holmium Laser Lithotripsy Work?
The Holmium laser produces pulses of light energy at a wavelength that is absorbed by water and stone material. When the laser fibre touches the stone, the energy fragments it into tiny pieces (dust) or small fragments. The laser can treat all stone compositions — calcium oxalate, uric acid, struvite, and cystine stones. It also has a coagulation effect, reducing bleeding during the procedure.
When is Laser Lithotripsy Used?
- Ureteric stones — stones stuck in the ureter causing pain and obstruction
- Moderate-sized kidney stones (1-2 cm) in the renal pelvis
- Stones that fail to pass spontaneously
- Stones resistant to ESWL (shockwave lithotripsy)
- Steinstrasse — a column of stone fragments blocking the ureter after ESWL
- Stones in patients with bleeding disorders — the Holmium laser coagulates tissue
- Stones in transplant kidneys or abnormal anatomy
The Procedure
Anaesthesia
General or spinal anaesthesia is given. The procedure typically takes 30-60 minutes.
Ureteroscopy
A thin, flexible ureteroscope is passed through the urethra into the bladder. It is then guided up the ureter to the location of the stone. The stone is visualised on a monitor.
Laser Fragmentation
A Holmium laser fibre (200-365 micron) is passed through the ureteroscope. The laser is activated in short pulses to fragment the stone. The stone is dusted (turned to fine powder) or fragmented into small pieces.
Stone Extraction
Larger fragments may be extracted using a stone basket (Dormia basket). A DJ stent may be placed at the end to ensure urine drainage and allow the ureter to heal.
Completion
The ureteroscope is removed. Most patients go home the same day or next morning. A DJ stent, if placed, is removed after 2-4 weeks.
Advantages
Recovery
- Most patients go home the same day or next morning
- Mild burning on urination for 2-3 days is normal
- Blood in urine for 1-2 weeks is expected
- If a DJ stent is placed, it is removed after 2-4 weeks
- Return to work in 3-5 days
- Drink 2-3 litres of water daily to flush fragments
- Follow-up X-ray to confirm complete stone clearance
Kidney Stone Prevention Tips
- •Drink 2.5-3 litres of water daily — your urine should be clear or pale yellow
- •Reduce sodium intake to less than 2g per day
- •Limit animal protein (meat, eggs) to reduce uric acid and calcium oxalate
- •Eat calcium-rich foods (but avoid supplements unless prescribed)
- •Limit oxalate-rich foods — spinach, nuts, chocolate, tea
- •Maintain a healthy weight — obesity increases stone risk
- •Get stone composition analysis to guide specific prevention
- •Metabolic evaluation if you have recurrent stones
Kidney Stone Treatment? Consult Dr. Goel
Dr. Rajesh Goel provides expert evaluation of kidney stones and recommends the most appropriate treatment — laser lithotripsy, PCNL, or conservative management — based on your stone characteristics.