You have accessJournal of UrologyStone Disease: Evaluation & Medical Management I1 Apr 20122123 HOLMIUM:YAG OPTICAL FIBER BURNBACK VARIES WITH STONE COMPOSITION Jennifer Castelbuono, Joel Teichman, and Bodo Knudsen Jennifer CastelbuonoJennifer Castelbuono Columbus, OH More articles by this author , Joel TeichmanJoel Teichman Vancouver, Canada More articles by this author , and Bodo KnudsenBodo Knudsen Columbus, OH More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2012.02.2292AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Optical fiber tip degradation (fiber burnback) occurs at variable rates during laser lithotripsy of renal stones. Prior research showed more fiber damage with calcium oxalate monohydrate (COM), calcium phosphate (CP), and struvite stones compared to uric acid stones. We hypothesize that the rate of fiber burnback varies with stone composition. METHODS An ex-vivo testing apparatus was used to bring a 240 μm core sized optical fiber into contact with stones of known composition (UA, CP, COM, and artificial Bego). Lead tape was used to ensure consistent pressure was applied to the stone. The holmium YAG laser was activated until 100 J were delivered. Settings of 400 mJ and 1500 mJ at 5Hz were tested for all stone compositions. The amount of fiber burnback was measured. Fiber energy transmission was measured before and after each trial. Multiple trials with each stone composition were performed. RESULTS Contact with COM and CP stones resulted in greater burnback than with UA stones at both 400 mJ and 1500 mJ (p < 0.05). Contact with Bego stones resulted in similar burnback to COM and CAP stones, but greater than UA stones (p < 0.05). For COM, CP, and Bego stone compositions, burnback increased at the higher pulse energy setting (p < 0.05). Pulse energy did not alter the rate of burnback with UA stones. Fiber energy transmission did not change. CONCLUSIONS Optical fiber burnback varies with stone composition and pulse energy setting with the exception of UA stones. Fiber burnback did not alter energy transmission. These findings are consistent with prior studies. A strategy of low pulse energy and high pulse repetition should minimize burnback while maintaining fragmentation efficiency. COHORT BURNBACK MEAN (μm) ENERGY TRANSMISSION (mJ) Bego (400 mJ) 0.148 535 Bego (1500 mJ) 0.787 481 Uric Acid (400 mJ) 0.026 515 Uric Acid (1500 mJ) 0.024 510 COM (400 mJ) 0.1 498 COM (1500 mJ) 0.671 500 CP (400 mJ) 0.175 511 CP (1500 mJ) 0.561 512 © 2012 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 187Issue 4SApril 2012Page: e857 Advertisement Copyright & Permissions© 2012 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jennifer Castelbuono Columbus, OH More articles by this author Joel Teichman Vancouver, Canada More articles by this author Bodo Knudsen Columbus, OH More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...