Clinical Comparison of Super Pulse Thulium Fiber Laser and High-Power Holmium Laser for Ureteral Stone Management.

PURPOSE To evaluate efficacy of new Super Pulse Thulium Fiber Laser and compare it with Holmium laser for ureterolithotripsy. PATIENTS AND METHODS A total of 174 patients with solitary ureteral calculi were enrolled in 2016-2018. Stone sizes ranged between 0.6 and 2.4 cm. The SPTFL FiberLaseU2 and 120H Ho:YAG laser with fibers diameters of 400 µm and 365 µm respectively were used. The laser settings were 1J x10Hz=10W for both devices. All patients were randomized into two groups. The age, stone size, location, and density were comparable in both groups. The evaluated parameters were operations time, endoscopic view quality, retropulsion grade, stone-free and complication rates. RESULTS The total operation and lasering times were longer in the Ho:YAG group (24.7 ± 0.7 vs 32.4 ± 0.7 min, p 0.05), postoperative stenting was necessary in 1 vs 4 cases, respectively. At 30-days follow-up no residual stones were seen in SP TFL group (vs 5 cases of Ho:YAG). CONCLUSION SP TFL technology was associated with excellent efficacy/safety ratio. The SP TFL may be considered as a viable alternative to Ho:YAG laser stone management.