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Temperature profiles of calyceal irrigation fluids during flexible ureteroscopic Ho:YAG laser lithotripsy

  • Urology - Original Paper
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Abstract

Purpose

To evaluate calyceal irrigation fluid temperature changes during flexible ureteroscopic Ho:YAG laser lithotripsy.

Methods

Between May 2019 and January 2020, patients with kidney stones undergoing flexible ureteroscopic Ho:YAG laser lithotripsy were enrolled. A K-type thermocouple was applied for intraoperative temperature measurement. Laser was activated at different power (1 J/20 Hz and 0.5 J/20 Hz) and irrigation (0 ml/min, 15 ml/min and 30 ml/min) settings, temperature–time curve was drawn and time needed to reach 43 °C without irrigation was documented.

Results

Thirty-two patients were enrolled in our study. The temperature–time curve revealed a quick temperature increase followed by a plateau. With 15 ml/min or 30 ml/min irrigation, 43 °C was not reached after 60 s laser activation at both 1 J/20 Hz and 0.5 J/20 Hz. At the power setting of 1 J/20 Hz and irrigation flow rate of 15 ml/min, the temperature rise was significantly higher than other groups. Without irrigation, the time needed to reach 43 °C at 1 J/20 Hz was significantly shorter than that at 0.5 J/20 Hz (8.84 ± 1.41 s vs. 13.71 ± 1.53 s).

Conclusion

Ho:YAG laser lithotripsy can induce significant temperature rise in calyceal fluid. With sufficient irrigation, temperatures can be limited so that a toxic thermal dose is not reached, when irrigation is closed, the temperature increased sharply and reached 43 °C in a few seconds.

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Data availability

The data used and analyzed in the current study are available from the corresponding author on reasonable request.

Abbreviations

SWL:

Shockwave lithotripsy

URS:

Ureteroscopy

PCNL:

Percutaneous nephrolithotomy

RIRS:

Retrograde intrarenal surgeries

Ho:YAG:

Holmium:yttrium aluminum garnet

SD:

Standard deviation

ANOVA:

Analysis of variance

BMI:

Body mass index

CEM43 :

Cumulative equivalent minutes at 43 °C

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Funding

This work was funded by National Natural Science Foundation of China (no. 81400701).

Author information

Authors and Affiliations

  1. Department of Urology, The Seventh Medical Center of Chinese PLA General Hospital, No 5 Nanmencang, Beijing, 100700, China

    Jingfei Teng, Zhuomin Jia, Yawei Guan & Xing Ai

  2. Department of Urology, The Sixth Medical Center of Chinese PLA General Hospital, Beijing, 100048, China

    Yi Wang

  3. Department of Anesthesiology, The Seventh Medical Center of Chinese PLA General Hospital, Beijing, 100700, China

    Weiwei Fei

  4. The Second School of Clinical Medicine, Southern Medical University, Beijing, 100700, China

    Xing Ai

Authors
  1. Jingfei Teng
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  3. Zhuomin Jia
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Contributions

Conception and design: JT and XA; Collection and assembly of data: YW, ZJ, YG and WF; Analysis and interpretation of data: JT, YW and ZJ; Drafting of the manuscript: JT and ZJ; Revision of the manuscript: XA; Supervision: XA. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Xing Ai.

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The authors declare that they have no competing interests.

Ethics approval

The study was conducted in accordance to the principles of Declaration of Helsinki. Approval was granted by the Ethics Committee of The Seventh Medical Center of Chinese PLA General Hospital.

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Informed consent was obtained from all individual participants included in the study.

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Teng, J., Wang, Y., Jia, Z. et al. Temperature profiles of calyceal irrigation fluids during flexible ureteroscopic Ho:YAG laser lithotripsy. Int Urol Nephrol 53, 415–419 (2021). https://doi.org/10.1007/s11255-020-02665-x

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