V02-12 URETEROCELE EXCISIONAL TECHNIQUE USING THULIUM LASER

Abstract

You have accessJournal of UrologyCME1 Apr 2023V02-12 URETEROCELE EXCISIONAL TECHNIQUE USING THULIUM LASER Jordan Krieger, Ali Antar, and Margaret Knoedler Jordan KriegerJordan Krieger More articles by this author , Ali AntarAli Antar More articles by this author , and Margaret KnoedlerMargaret Knoedler More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003232.12AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Ureteroceles are cystic dilations of the distal ureter at its insertion site into the bladder and occur in 1 in 1000 births. Endoscopic intervention is minimally invasive and can alleviate obstruction in >95% of cases. The Thulium laser is a relatively new laser with a 1940 nm wavelength and a four times higher absorption in water than the Holmium laser. This theoretically leads to better tissue ablation and hemostasis. Our objective is to demonstrate the safety and efficacy of Thulium laser use for excision of ureteroceles. METHODS: This is a 22-year-old patient with normal renal function and a complex urologic history including bilateral duplicated collecting systems, vesicoureteral reflux with bilateral deflux injections, a right-sided ureterocele, and recurrent urinary tract infections resulting in hospitalizations for pyelonephritis. She was taken to the operating room for an endoscopic right ureterocele excision using Thulium laser. We used the Soltive SuperPulsed Thulium Fiber Laser (200 micron) with settings of 1 joule (J) for pulse energy and 20 hertz for frequency (20 watts). Total energy used was 2756 J. Tissue ablation and hemostasis were excellent, and no additional time was required at the end of the case to obtain hemostasis from the excised edges. She discharged the same day without issues. RESULTS: Six weeks later the patient followed-up in our clinic with a renal ultrasound demonstrating no hydronephrosis and a decompressed ureterocele. She denied any flank pain or recurrent infections. CONCLUSIONS: Thulium laser excision is a safe and efficacious treatment option for management of symptomatic ureteroceles. It showed excellent tissue ablation and hemostatic properties. Source of Funding: None © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e172 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Jordan Krieger More articles by this author Ali Antar More articles by this author Margaret Knoedler More articles by this author Expand All Advertisement PDF downloadLoading ...