Innovative use of the new pulsed-thulium: YAG laser for ureteroscopic lithotripsy: can the "kidney stone calculator" predict lithotripsy duration?

To assess the accuracy of Kidney Stone Calculator(KSC), a software designed for surgical planning, in predicting the duration of lithotripsy during flexible ureteroscopy(FURS) when using the novel pulsed-Thulium: YAG(p-Tm: YAG) laser. From February to August 2023, a single-center prospective study was conducted, including patients with kidney or ureteral stones through non-contrast computed tomography(NCCT), who underwent FURS with p-Tm: YAG laser lithotripsy. KSC used three-dimensional segmentation of the stones from NCCT images, along with an interactive user interface for laser settings, to estimate the stone volume(SV) and the lithotripsy duration(LD).

Thulium fiber laser versus pulsed Thulium:YAG for laser lithotripsy during flexible ureteroscopy.

To compare the pulsed-Thulium: YAG(p-Tm: YAG) and Thulium Fiber(TFL) lasers in terms of efficiency and safety profiles during flexible ureteroscopy(fURS) and endocorporeal laser lithotripsy(ELL). A prospective single-center open-label comparative study included consecutive patients with ureteral and renal stones who underwent fURS using Thulio(p-Tm: YAG, Dornier©,Germany) or TFL Drive(TFL, Coloplast©,Danemark), with 270 μm and 150/200μm laser fibers(LF), respectively. fURS were performed by a single operator in each group.

Comparison of Pulsed-Thulium:YAG, Holmium:YAG, and Thulium Fiber Laser.

To characterize the pulse characteristics and risk of fiber fracture (ROF) of the pulsed-Thulium:YAG (p-Tm:YAG) laser and to compare its ablation volumes (AVs) against Holmium:Yttrium-Aluminium-Garnet (Ho:YAG) laser and Thulium fiber laser (TFL). p-Tm:YAG (100 W-Thulio, Dornier-Medtech, Germany) was characterized using single-use 272 μm core-diameter-fibers. p-Tm:YAG characterization included pulse shape, duration, and peak power (PP) studies.

Ureteroscopic management in cystinuric patients: long-term results from a tertiary care referral center.

Objective: To evaluate long-term surgical and functional outcomes of cystinuric patients exclusively treated with Ureteroscopy (URS).

Methods: Data from patients treated for cystine stones at a single academic center were retrospectively analyzed. The management protocol consisted of (i) treating symptomatic or > 7 mm stones, (ii) multi-staged URS for voluminous stones, (iii) referring patients to a dedicated nephrological clinic.

Ureteral stents: What your eyes can't see! An in vitro study.

Objectives: To characterize and compare in vitro the surfaces of ureteral stents (STENTS) before utilization.

Methods: Our in vitro experiment included six unused STENTS models: three double-pigtail with side orifices (ImaJin and Stenostent [Coloplast©,France], TriaSoft [BostonScientific©,USA]), two double-pigtail without side orifice (Vortek-TumorStent [Coloplast©,France], Urosoft-TumorStent [Bard-Angiomed©,Germany]) and one single-pigtail (J-Fil [Rocamed©,Monaco]). STENTS were made of polyurethane except for ImaJin (silicone).

Asymptomatic Bacteriuria and Urological Surgery: Risk Factor or Not? Results From the National and Multicenter TOCUS Database.

Purpose: Current guidelines recommend screening and treatment of asymptomatic bacteriuria prior to all urological surgeries breaching the mucosa. But little evidence supports this recommendation. At the least, risk stratification for postoperative UTI to support this strategy is lacking.

Is "Kidney Stone Calculator" efficient in predicting ureteroscopic lithotripsy duration? A holmium:YAG and thulium fiber lasers comparative analysis.

Purpose: This study aimed to evaluate the ability of Kidney Stone Calculator (KSC), a flexible ureteroscopy surgical planning software, to predict the lithotripsy duration with both holmium:YAG (Ho:YAG) and thulium fiber laser (TFL).

Methods: A multicenter prospective study was conducted from January 2020 to April 2023. Patients with kidney or ureteral stones confirmed at non-contrast computed tomography and treated by flexible ureteroscopy with laser lithotripsy were enrolled.

Asymptomatic bacteriuria prior to partial and radical nephrectomy: To screen or not to screen? Results from the national and multicenter TOCUS database.

Introduction: In the era of increased bacterial resistance, the main strategy is to reduce the prescription of antibiotics when possible. Nowadays, it is highly recommended to screen for asymptomatic bacteriuria (ABU), prior to urological surgery with potential mucosal breach or urine exposure. Screening and treating urinary colonization is a strategy widely adopted before radical and partial nephrectomy but without any evidence.

Management of urosymphyseal fistula and pubic bone osteomyelitis: Description of a new surgical technique by cystectomy, urinary diversion and pelvic filling flap by unilateral pedicled myocutaneous vertical rectus abdominus muscle flap.

Pubic bone osteomyelitis is a rare infection, mostly related to urinary fistula. The published data about the medical or surgical management of this type of infection is relatively poor. In this case study of three patients, we describe our surgical technique for the management of urosymphyseal fistula complicated with pubic bone infection using pelvic filling flap by unilateral pedicled myocutaneous vertical rectus abdominus muscle flap.

Thulium:YAG laser: a good compromise between holmium:YAG and thulium fiber laser for endoscopic lithotripsy? A narrative review.

Purpose: To provide a technological description of the new pulsed solid-state Thulium:YAG laser (Tm:YAG). In addition, current available literature on Tm:YAG lithotripsy is also reviewed.

Materials And Methods: Medline, Scopus, Embase, and Web of Science databases were used to search for Tm:YAG operating mode articles.

How to estimate stone volume and its use in stone surgery: a comprehensive review.

Objective: Current interventional guidelines refer to the cumulative stone diameter to choose the appropriate surgical modality (ureteroscopy [URS], extracorporeal shockwave lithotripsy [ESWL] and percutaneous nephrolithotomy [PCNL]). The stone volume (SV) has been introduced recently, to better estimate the stone burden. This review aimed to summarize the available methods to evaluate the SV and its use in urolithiasis treatment.

Endoscopic Conservative Treatment of Upper Urinary Tract Urothelial Carcinoma with a Thulium Laser: A Systematic Review.

Introduction: Thulium lasers (TLs), namely the Thulium fiber laser (TFL) and the Thulium:YAG (Tm:YAG), are being increasingly adopted for the conservative treatment of upper urinary tract urothelial carcinoma (UTUC). However, to date, the real clinical impact of TLs on UTUC management remains not well-characterized. We performed a review of the literature to summarize the current evidence on TLs for UTUC treatment.

Ablation rates with Holmium:YAG and Thulium Fiber Laser: Influence of the stone phantom homogeneity. An in vitro study.

Objectives: The lithotripsy efficiency (LE) in vitro study requires artificial or human stone samples (AS, HS). With the development of dusting lithotripsy, less ex vivo HS are available. We aimed to compare Thulium Fiber Laser (TFL) and Holmium:YAG (Ho:YAG)'s LE and define the most accurate LE parameter.

Initial clinical experience with the pulsed solid-state thulium YAG laser from Dornier during RIRS: first 25 cases.

Introduction: Holmium:yttrium-aluminium-garnet (Ho:YAG) and thulium fiber (TFL) lasers are currently the two laser sources recommended for endocorporeal laser lithotripsy (ELL). Recently, the pulsed-thulium:YAG (Tm:YAG) laser was also proposed for ELL, as an answer to both Ho:YAG and TFL limitations. We aimed to evaluate the efficiency, safety, and laser settings of Tm:YAG laser in ELL during retrograde intrarenal surgery (RIRS).

Optimizing Outcomes in Flexible Ureteroscopy: A Narrative Review of Suction Techniques.

Objective: The aim of this review is to summarize the existing suction systems in flexible ureteroscopy (fURS) and to evaluate their effectiveness and safety.

Methods: A narrative review was performed using the Pubmed and Web of Science Core Collection (WoSCC) databases. Additionally, we conducted a search on the Twitter platform.