Comparative Laser Efficacy and Clinical Outcomes of Pulsed Thulium:YAG versus Standard Holmium:YAG Lithotripsy.

IF 1.2 4区医学 Q3 UROLOGY & NEPHROLOGY

Urologia Internationalis Pub Date : 2026-10-01 DOI:10.1159/uin/aewag005

Yusuke Shirasu, Takashi Yoshida, Yutaro Oku, Shogo Murakami, Gen Kawa

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Abstract

Introduction: The objective of this study was to compare the efficacy and clinical outcomes of ureteroscopic lithotripsy using the holmium:YAG laser (Ho:YAG) and pulsed thulium:YAG laser (p-Tm:YAG: RevoLix HTL, LISA Laser Products, Germany) for upper urinary tract stones.

Methods: This retrospective single-center study included patients who underwent ureteroscopy for kidney or ureteral stones between August 2023 and August 2025. Patients with bilateral stones, concomitant procedures, stones ≥20 mm, or without preoperative computed tomography imaging were excluded. Endpoints included operative time, laser efficacy (ratio of cumulative stone volume to operative time), and the stone-free rate (SFR).

Results: We analyzed 104 patients (Ho:YAG, n = 54; p-Tm:YAG, n = 50). The p-Tm:YAG group exhibited significantly shorter operative time (46.0 vs. 66.5 min, p < 0.001) and higher laser efficacy (0.237 vs. 0.175 mm3/min, p = 0.016). Subgroup analysis revealed that p-Tm:YAG exhibited significantly shorter operative times (49.0 vs. 96.0 min, p < 0.001) and superior laser efficacy (0.252 vs. 0.183 mm3/min, p = 0.008) for stones measuring 10-20 mm, whereas similar outcomes were observed for stones <10 mm between the two groups. The Ho:YAG and p-Tm:YAG groups exhibited similar SFRs on postoperative day 1 (79.6% vs. 88.0%, p = 0.182) and at 1 month (87.0% vs. 92.0%, p = 0.325).

Conclusion: Both lasers achieved comparable and high SFRs for stones <20 mm. However, the p-Tm:YAG laser offers higher laser efficacy and significantly shorter operative times, particularly for larger stones (10-20 mm), supporting its use as an efficient alternative to the Ho:YAG laser.

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脉冲钬激光碎石与标准钬激光碎石的激光疗效及临床效果比较。

目的：比较输尿管镜下钬激光（Ho: YAG）和脉冲铥激光（p-Tm: YAG: RevoLix HTL, LISA laser Products, Germany）治疗上尿路结石的疗效和临床结果。材料和方法：本回顾性单中心研究纳入了2023年8月至2025年8月期间因肾脏或输尿管结石接受输尿管镜检查的患者。排除双侧结石、合并手术、结石≥20mm或术前未进行计算机断层扫描的患者。终点包括手术时间、激光疗效（累积结石体积与手术时间之比）和结石去除率（SFR）。结果：我们分析了104例患者（Ho: YAG, n=54; p-Tm: YAG, n=50）。p-Tm: YAG组的手术时间明显缩短（46.0 min vs. 66.5 min）。结论：两种激光治疗结石的SFRs相当且较高

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来源期刊

Urologia Internationalis 医学-泌尿学与肾脏学

CiteScore

3.30

自引率

6.20%

发文量

审稿时长

3-8 weeks

期刊介绍： Concise but fully substantiated international reports of clinically oriented research into science and current management of urogenital disorders form the nucleus of original as well as basic research papers. These are supplemented by up-to-date reviews by international experts on the state-of-the-art of key topics of clinical urological practice. Essential topics receiving regular coverage include the introduction of new techniques and instrumentation as well as the evaluation of new functional tests and diagnostic methods. Special attention is given to advances in surgical techniques and clinical oncology. The regular publication of selected case reports represents the great variation in urological disease and illustrates treatment solutions in singular cases.