Which is the best way to treat a stone on a flexible ureterorrenoscopy? | Opinion: Dusting

Vol. 43 (5): 802-804, September – October, 2017

doi: 10.1590/S1677-5538.IBJU.2017.05.03


DIFFERENCE OF OPINION

Antonio Correa Lopes Neto 1
1 Grupo de Litíase e Endourologia da Disciplina de Urologia da Faculdade de Medicina ABC, Santo André, SP, Brasil

Keywords: Calculi; Lasers, Solid-State; Kidney


Flexible ureterorenolithotripsy is rapidly developing and becoming the treatment of choice around the World for the invasive treatment of lithiasis (1). According to calculi dimensions, they can be removed integrated or by using an intracorporeal lithotripter. According to laser parameters adjustments, it is possible to vaporize calculi (“dusting”). In this case, it is necessary to use high frequency of impulses (>15HZ), low energy (<0.5J) and long pulses (800 ᶭsec), whenever the equipment allows for these options. Recently, it has been debated which is the best way to program the equipment at the moment of calculi lithotripsy. There are few evidences in literature to conclude, but it seems that dusting has some advantages in relation to fragmentation + basketing…

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