PD45-08 THULIUM FIBER LASER VS HOLMIUM:YAG LASER: A PROSPECTIVE CASE-CONTROL STUDY IN LARGE URETERIC STONES

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You have accessJournal of UrologyCME1 Apr 2023PD45-08 THULIUM FIBER LASER VS HOLMIUM:YAG LASER: A PROSPECTIVE CASE-CONTROL STUDY IN LARGE URETERIC STONES Mohamed Hatem, Abdullah Aljarod, Hatem Kamkoum, Tawiz Gul, Mohamed Ebrahim, Mohamad Rejeb, Kalpana Singh, Abdulla AL-Ansari, Omar Aboumarzouk, and Morshed Salah Mohamed HatemMohamed Hatem More articles by this author , Abdullah AljarodAbdullah Aljarod More articles by this author , Hatem KamkoumHatem Kamkoum More articles by this author , Tawiz GulTawiz Gul More articles by this author , Mohamed EbrahimMohamed Ebrahim More articles by this author , Mohamad RejebMohamad Rejeb More articles by this author , Kalpana SinghKalpana Singh More articles by this author , Abdulla AL-AnsariAbdulla AL-Ansari More articles by this author , Omar AboumarzoukOmar Aboumarzouk More articles by this author , and Morshed SalahMorshed Salah More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003358.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: The new Thulium Fiber Laser (TFL) has been recently introduced as an alternative lithotripsy technology. TFL is a promising alternative to Holmium:YAG (Ho:YAG) owing to its use of a more suitable TFL wavelength, smaller fibers, and potential for using a smaller and less expensive laser system. TFL has already showed its efficacy and safety in lithotripsy. We aimed to compare between TFL and Ho:YAG ureteroscopic lithotripsy for large stones >1cm. METHODS: We prospectively case controlled studied patients with ureteral calculi in the period between June 2020-July 2022. All adult patients with ureteric stones that required to undergo ureterolithotripsy were included. TFL or HO:YAG were used alternatively between the two modalities. The age, co-morbidities, body mass index (BMI), stone size, and volume were recorded. The evaluated parameters were stone-free rate (SFR), operative time, and complication rate. The surgical research section review board approved the study. Chi-Square tests with standardized residuals were calculated to see association with categorical variables and the groups. RESULTS: A total of 172 adult patients with ureteric stones >1cm were included in this study. 87 patients in the TFL group with a mean age of 37.9+-8.8 and 85 in the Ho:YAG group with a mean age of 39.4+-10.5 (p=0.34). There was no difference regarding BMI (26+-3.6 vs 26+-3.7)(p=0.96), Co-morbidity (16% vs 24% with multiple comorbidities)(p=0.49), anaesthesia type using general or spinal (57% vs 55%) (p=0.77), stone volume (1.6+-0.5 vs 1.5+-0.5)(p=0.41), or basket use (15% vs 15%)(p=0.95). Interestingly, the TFL group took longer to perform, with higher operative time than the Ho:YAG group (81.7+-42.2 vs 67+-35.1 (p=0.016)). This was likely due to the fact the TFL group did have more multiple stones requiring lithotripsy than the Ho:YAG group, however this was not statistically significant, but clearly, clinically significant whereby there was a 27% vs 19% multiple stones rate (p=0.23). There was no difference in the SFR (95% vs 96% (p=0.72)), second look ureteroscopy (14% vs 8%) (p=0.25)) or early or late complication rates, 1% vs 4% (p=0.3) and 0% vs. 1% (p=0.31), respectively. All patients were stone and complication free on follow up. CONCLUSIONS: TFL has proven its efficacy and safety with high SFR and low early and late complication rates. TFL ureteroscopic lithotripsy took longer to perform than Ho:YAG, probably due to having a higher stone burden, however statistically not significant. Source of Funding: No funding for this review was received. © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1165 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mohamed Hatem More articles by this author Abdullah Aljarod More articles by this author Hatem Kamkoum More articles by this author Tawiz Gul More articles by this author Mohamed Ebrahim More articles by this author Mohamad Rejeb More articles by this author Kalpana Singh More articles by this author Abdulla AL-Ansari More articles by this author Omar Aboumarzouk More articles by this author Morshed Salah More articles by this author Expand All Advertisement PDF downloadLoading ...