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

doi:10.1016/S0022-5347(01)62883-0

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

Ophthalmology

Research output: Contribution to journal › Article › peer-review

34 Scopus citations

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 language	English (US)
Pages (from-to)	320-324
Number of pages	5
Journal	Journal of Urology
Volume	160
Issue number	2
DOIs	https://doi.org/10.1016/S0022-5347(01)62883-0
State	Published - Aug 1998

Keywords

Holmium
Lithotripsy, laser
Uric acid, calculi

ASJC Scopus subject areas

Urology

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10.1016/S0022-5347(01)62883-0

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@article{f489aeb367f545c78034b7bba5df1081,

title = "Holmium:YAG lithotripsy: Photothermal mechanism converts uric acid calculi to cyanide",

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.",

keywords = "Holmium, Lithotripsy, laser, Uric acid, calculi",

author = "Teichman, {Joel M.H.} and Vassar, {George J.} and Glickman, {Randolph D.} and Beserra, {Cara M.} and Cina, {Stephen J.} and Thompson, {Ian M}",

note = "Funding Information: Supported by an unrestricted grant from Research to Prevent Blindness to the Department of Ophthalmology. ",

year = "1998",

month = aug,

doi = "10.1016/S0022-5347(01)62883-0",

language = "English (US)",

volume = "160",

pages = "320--324",

journal = "Investigative Urology",

issn = "0022-5347",

publisher = "Elsevier Inc.",

number = "2",

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TY - JOUR

T1 - Holmium:YAG lithotripsy

T2 - Photothermal mechanism converts uric acid calculi to cyanide

AU - Teichman, Joel M.H.

AU - Vassar, George J.

AU - Glickman, Randolph D.

AU - Beserra, Cara M.

AU - Cina, Stephen J.

AU - Thompson, Ian M

N1 - Funding Information: Supported by an unrestricted grant from Research to Prevent Blindness to the Department of Ophthalmology.

PY - 1998/8

Y1 - 1998/8

N2 - 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.

AB - 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.

KW - Holmium

KW - Lithotripsy, laser

KW - Uric acid, calculi

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

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