Effect of temporal pulse shape on urinary stone phantom retropulsion rate and ablation efficiency using Holmium:YAG and Super Pulse Thulium Fiber lasers.

OBJECTIVE: To investigate the effects of laser temporal pulse shaping of the super pulse Thulium fiber laser (SPTFL) and to compare them in controlled in vitro conditions with various Ho:YAG pulse delivery modes. MATERIALS AND METHODS: SPTFL (Urolase SP, IRE-Polus, Fryazino, Russia) with an emission wavelength of 1.94 mum and a Ho:YAG laser (P120H, Lumenis, Yokneam, Israel) with Moses technology were compared. Pulse shape, stone retropulsion, and ablation efficiency were evaluated using Begostones and compared for each laser modality: short (SP), long (LP), and Moses pulse (MP) for Ho:YAG, regular pulse (RP) and dual pulse (DP) for SPTFL. RESULTS: Ho:YAG SP mode exhibited an asymmetrical pulse shape with steep leading slope and much more gradual trailing slope, without any flat section. Pulses generated by SPTFL were significantly longer and therefore had lower peak power (Ppeak) than those generated by Ho:YAG laser at equivalent energy settings. Retropulsion for Ho:YAG LP and MP modes was similar and lower than that of SP, but higher than for SPTFL (all p