Holmium: YAG lithotripsy: Photothermal mechanism converts uric acid calculi to cyanide

Joel M H Teichman, George J. Vassar, Randolph D Glickman, Cara M. Beserra, Stephen J. Cina, Ian M. Thompson

Research output: Contribution to journalArticle

34 Citations (Scopus)

Abstract

Purpose: Holmium:YAG lithotripsy fragments stones through a photothermal mechanism. Uric acid when heated is known to be converted into cyanide. We test the hypothesis that holmium: YAG lithotripsy of uric acid calculi produces cyanide. Materials and Methods: Human calculi of known uric acid composition were irradiated with holmium:YAG energy in water. Stones received a total holmium:YAG energy of 0 (control), 0.1, 0.25, 0.5, 0.75, 1.0 or 1.25 kJ. The water in which lithotripsy was performed was analyzed for cyanide concentration. A graph was constructed to relate holmium:YAG energy to cyanide production. Results: Holmium:YAG lithotripsy of uric acid calculi in vitro produced cyanide consistently. Cyanide production correlated with total holmium:YAG energy (p<0.001). Conclusions: Holmium:YAG lithotripsy of uric acid calculi risks production of cyanide. This study raises significant safety issues.

Original languageEnglish (US)
Pages (from-to)320-324
Number of pages5
JournalJournal of Urology
Volume160
Issue number2
DOIs
StatePublished - 1998
Externally publishedYes

Fingerprint

Holmium
Lithotripsy
Calculi
Cyanides
Uric Acid
Water
Safety

Keywords

  • Holmium
  • Lithotripsy, laser
  • Uric acid, calculi

ASJC Scopus subject areas

  • Urology

Cite this

Teichman, J. M. H., Vassar, G. J., Glickman, R. D., Beserra, C. M., Cina, S. J., & Thompson, I. M. (1998). Holmium: YAG lithotripsy: Photothermal mechanism converts uric acid calculi to cyanide. Journal of Urology, 160(2), 320-324. https://doi.org/10.1016/S0022-5347(01)62883-0

Holmium : YAG lithotripsy: Photothermal mechanism converts uric acid calculi to cyanide. / Teichman, Joel M H; Vassar, George J.; Glickman, Randolph D; Beserra, Cara M.; Cina, Stephen J.; Thompson, Ian M.

In: Journal of Urology, Vol. 160, No. 2, 1998, p. 320-324.

Research output: Contribution to journalArticle

Teichman, Joel M H ; Vassar, George J. ; Glickman, Randolph D ; Beserra, Cara M. ; Cina, Stephen J. ; Thompson, Ian M. / Holmium : YAG lithotripsy: Photothermal mechanism converts uric acid calculi to cyanide. In: Journal of Urology. 1998 ; Vol. 160, No. 2. pp. 320-324.
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