ArticleWorld journal of urology2024
Experts' recommendations in laser use for the treatment of urolithiasis: a comprehensive guide by the European Section of Uro-Technology (ESUT) and Training-Research in Urological Surgery and Technology (T.R.U.S.T.)-Group.
Article in World journal of urology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Stone dust in endourology: a systematic review of its definition, management, and clinical impact.BJU international · 2025Pooled it
- Intrarenal thermal and pressure dynamics during ureteroscopy: an in vitro study.BJU international · 2026Article
- Objective assessment of turbidity during laser lithotripsy: standardization of a dedicated in vitro experimental model.World journal of urology · 2026Article
- Flexible ureterorenoscopy with holmium laser lithotripsy for ureteral calculi complicated by hydronephrosis.American journal of translational research · 2026Article
- In vitro comparative analysis of ablation volume and energy requirements for 1 mm³ stone ablation using ho: YAG, p-Tm: YAG, and TFL lasers.Urolithiasis · 2025Article
- Characterisation of iatrogenic human ureteral laser injury - results from ex vivo testing with a Ho: YAG laser at commonly used lithotripsy settings.World journal of urology · 2025Article
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33 authors.
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Abstract
purposeTo identify laser lithotripsy settings used by experts for specific clinical scenarios and to identify preventive measures to reduce complications.
methodsAfter literature research to identify relevant questions, a survey was conducted and sent to laser experts. Participants were asked for preferred laser settings during specific clinical lithotripsy scenarios. Different settings were compared for the reported laser types, and common settings and preventive measures were identified.
resultsTwenty-six laser experts fully returned the survey. Holmium-yttrium-aluminum-garnet (Ho:YAG) was the primary laser used (88%), followed by thulium fiber laser (TFL) (42%) and pulsed thulium-yttrium-aluminum-garnet (Tm:YAG) (23%). For most scenarios, we could not identify relevant differences among laser settings. However, the laser power was significantly different for middle-ureteral (p = 0.027), pelvic (p = 0.047), and lower pole stone (p = 0.018) lithotripsy. Fragmentation or a combined fragmentation with dusting was more common for Ho:YAG and pulsed Tm:YAG lasers, whereas dusting or a combination of dusting and fragmentation was more common for TFL lasers. Experts prefer long pulse modes for Ho:YAG lasers to short pulse modes for TFL lasers. Thermal injury due to temperature development during lithotripsy is seriously considered by experts, with preventive measures applied routinely.
conclusionsLaser settings do not vary significantly between commonly used lasers for lithotripsy. Lithotripsy techniques and settings mainly depend on the generated laser pulse's and generator settings' physical characteristics. Preventive measures such as maximum power limits, intermittent laser activation, and ureteral access sheaths are commonly used by experts to decrease thermal injury-caused complications.
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