Proteus mirabilis viability after lithotripsy of struvite calculi

Sabitha Prabakharan; Joel M. H. Teichman M.D.; Scott S. Spore; Edmund Sabanegh M.D.; Randolph D. Glickman; Robert J. C. McLean

doi:10.1117/12.386261

17 May 2000 Proteus mirabilis viability after lithotripsy of struvite calculi

Sabitha Prabakharan, Joel M. H. Teichman M.D., Scott S. Spore, Edmund Sabanegh M.D., Randolph D. Glickman, Robert J. C. McLean

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Proceedings Volume 3907, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems X; (2000) https://doi.org/10.1117/12.386261
Event: BiOS 2000 The International Symposium on Biomedical Optics, 2000, San Jose, CA, United States

Abstract

Urinary calculi composed of struvite harbor urease-producing bacteria within the stone. The photothermal mechanism of holmium:YAG lithotripsy is uniquely different than other lithotripsy devices. We postulated that bacterial viability of struvite calculi would be less for calculi fragmented with holmium:YAG irradiation compared to other lithotripsy devices. Human calculi of known struvite composition (greater than 90% magnesium ammonium phosphate hexahydrate) were incubated with Proteus mirabilis. Calculi were fragmented with no lithotripsy (controls), or shock wave, intracorporeal ultrasonic, electrohydraulic, pneumatic, holmium:YAG or pulsed dye laser lithotripsy. After lithotripsy, stone fragments were sonicated and specimens were serially plated for 48 hours at 38 C. Bacterial counts and the rate of bacterial sterilization were compared. Median bacterial counts (colony forming units per ml) were 8 X 10⁶ in controls and 3 X 10⁶ in shock wave, 3 X 10⁷ in ultrasonic, 4 X 10⁵ in electrohydraulic, 8 X 10⁶ in pneumatic, 5 X 10⁴ in holmium:YAG and 1 X 10⁶ in pulsed dye laser lithotripsy, p less than 0.001. The rate of bacterial sterilization was 50% for holmium:YAG lithotripsy treated stones versus 0% for each of the other cohorts, p less than 0.01. P. mirabilis viability is less after holmium:YAG irradiation compared to other lithotripsy devices.

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Sabitha Prabakharan, Joel M. H. Teichman M.D., Scott S. Spore, Edmund Sabanegh M.D., Randolph D. Glickman, and Robert J. C. McLean "Proteus mirabilis viability after lithotripsy of struvite calculi", Proc. SPIE 3907, Lasers in Surgery: Advanced Characterization, Therapeutics, and Systems X, (17 May 2000); https://doi.org/10.1117/12.386261

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KEYWORDS

Calculi

Control systems

Bacteria

Dye lasers

Ultrasonics

Magnesium

Acoustics

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