A medical device and method for breaking a concretion in a body into smaller pieces are described. The device comprises a combined probe including a laser waveguide probe and a nanosecond electro-pulse lithotripter probe. The method includes applying the laser waveguide probe to the surface of the concretion, and treating the surface with laser radiation to create a defect. The method also includes applying the nanosecond electro-pulse lithotripter probe to the area of the defect created by the laser waveguide probe, to provide a spark electrical discharge through the concretion.
