Effect of Holmium Laser on Cystine Stones

1. Cystine Stones Are Relatively Hard & Elastic Cystine has a compact, crystalline, sulfur-rich structure. Compared to calcium oxalate monohydrate, cystine is less brittle and more elastic, so it absorbs laser energy without fragmenting easily.

This means cystine stones resist “dusting” and often require more energy to break.

2. Lower Laser Absorption Efficiency Holmium laser works via photothermal fragmentation and micro-explosive vaporization of water at the stone surface.

Cystine has a lower intrinsic absorption of the holmium wavelength, so more energy is needed to produce the same effect seen with other stones.

The technique highlights optimized laser settings (higher energy, lower frequency), short pulse modulation, and dusting versus fragmentation.

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