THE USE OF LASERS IN ENDOSCOPIC AND OPEN UROLOGIC PROCEDURES IN CHILDREN

The neodymium: YAG laser is now the most common type of laser applied in pediatric surgery. The bare fibres with diameter of 400-mu-m and 600-mu-m can be introduced through the side channel of #8 cystoscope thus the cystoscopic laser can be used even in newborns. - Generally accepted power settings are not yet available for laser therapy in pediatric urology. After 5 years of systemic laser application in children standard parameters have been established. They follow the principle of reaching the desired therapeutic goal using the least energy at the shortest exposure time possible. In the non-contact method 15-25 watts, 0.1-0.3 sec pulses and 0.3 sec intervals are recommended for coagulation, and 100 watts in continuous waves for cutting. The same pulses and intervals are advisable for the contact method using the bare fibre, but 10- 12 watts are sufficient for coagulation and 20-25 for vaporization. With these settings all endoscopic procedures in pediatric urology such as the resection of urethral valves and structures, the ablation of ureteroceles and the treatment of hemangiomas can be performed.