ArticleInternational braz j urol : official journal of the Brazilian Society of Urology
Pulsed TM-YAG laser (Thulio®): a new weapon in endourologists' hand in the conservative management of imperative cases of Upper Tract Urothelial Carcinoma (UTUC).
Article in International braz j urol : official journal of the Brazilian Society of Urology. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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2 citing papers in PubMed.
- Conservative Management of Upper Tract Urothelial Carcinoma: A Narrative Review.Journal of clinical medicine · 2026Review
- Equation Predicts Renal Function after Nephroureterectomy to Treat Upper Tract Urothelial Carcinoma.International braz j urol : official journal of the Brazilian Society of UrologyArticle
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Abstract
introductionUrothelial carcinomas (UC) represent the sixth most common tumor by incidence, involving the lower or upper urinary tracts (UTUC) (1). High-risk patients should be treated by nephroureterectomy with complete bladder cuff excision (2), conservative approach is reserved for low-risk UTUCs and/or imperative cases (3). MATERIALS AND
methodsWe present a 70-year-old male patient, smoker, with history of urothelial carcinoma. He underwent distal ureterectomy with ileal replacement in April 2019. Since then, he has developed several UTUC recurrences bilaterally and in the bladder, which have been treated conservatively. In August 2023, CT- scan showed multiple recurrences in the left kidney and ureter. Hence, on November 2023, we performed cystoscopy, monopolar resection of bladder tumor and bilateral flexible ureteroscopy (fURS) with pulsed thulium:YAG (p-Tm:YAG) ablation of the tumors. We performed a no-touch technique fURS with Video Uretero-Renoscope FLEX-XC1 by Storz. After this, we placed an ureteral access sheath and then a biopsy by using a tipless basket. The laser fiber used was 272 µm and the laser settings were 0.8 J - 10 Hz - Long pulse Ablation (10 W).
resultsThe pathological results showed UTUC bilaterally and high-grade UC in the bladder. Then, he underwent intravenous therapy with enfortumab - vedotin and the follow-ups, in February 2024 and June 2024, showed no evidence of recurrences at the multiple biopsies.
conclusionThe p-Tm:YAG laser can be considered a valid alternative option for the conservative treatment of UTUCs. With that said, stringent follow-up remains a mainstay in the conservative treatment of imperative cases of UTUC.
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