ArticleBJUI compass2026
Power is not performance: Analysis of laser-use metrics from a randomised clinical trial comparing low- and high-power ureteroscopic lithotripsy.
Article in BJUI compass, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
2 citing papers in PubMed.
- Smart Lithotripsy: Lasers, Energy Sources and Efficiency.Current urology reports · 2026Review
- Power is not performance: Analysis of laser-use metrics from a randomised clinical trial comparing low- and high-power ureteroscopic lithotripsy.BJUI compass · 2026Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Objective: Thulium fibre laser (TFL) offers a wide range of power settings during ureteroscopic (URS) lithotripsy, yet the impact of power selection on intraoperative laser-use dynamics remains unclear. The objective of this study was to characterise differences in laser activation patterns between low-power (LP) and high-power (HP) TFL during sheathless URS. Materials and Methods: This was a predefined secondary analysis of intraoperative laser data collected during a randomised clinical trial comparing LP (0.4-0.6 J × 10 Hz; 4-6 W) and HP (0.4-0.8 J × 20-40 Hz; 16-18 W) TFL URS lithotripsy. Flexible URS was performed without a ureteral access sheath. Laser system logs provided time-stamped activation and pause events with microsecond precision. Laser-use dynamics were characterised using a predefined set of complementary metrics, including active laser time (ALT), laser operating time (LOT), total activation count, activation durations, pause durations and operator duty cycle (ODC = ALT/LOT). Group comparisons used Holm-Bonferroni-adjusted Results: Data from 72 LP and 74 HP procedures were analysed. ALT was longer with LP (23 vs. 13 min; Conclusion: LP and HP TFL lithotripsy result in distinctly different laser-use dynamics during sheathless URS. LP supported sustained, continuous lasing, whereas HP yielded fragmented activation requiring frequent pauses. Coupled with superior stone-free outcomes in the parent trial, these findings suggest that preserving clear endoscopic visibility and more active lasing may be more impactful than increasing laser power.
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Registered trials
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