EAU 2019: Prospective Clinical Study on Superpulse Thulium Fiber Laser: Initial Analysis of Optimal Laser Settings

Barcelona, Spain (UroToday.com) Recently, SuperPulse Thulium (Tm) fiber laser (NPO IRE-Polus) was introduced as a promising new laser technology for the management of stones and soft tissue. In a preclinical study, studies have proven its efficacy to be higher than the leading Ho:YAG laser for fragmentation and dusting for equal energy and repetition rate settings. In this work, authors reported results of the on-going clinical study aimed at comprehensive evaluation of safety and efficacy of the new laser.

Dr. Dymov and colleagues prospectively analyzed patients after SuperPulse Tm fiber laser lithotripsy. Stone size, its density and operative time were measured. Based on surgeon’s feedback, retropulsion and intraoperative visibility were assessed.

In this study, the average stone size was ranged from 7.6 - 22.2 mm. The mean stone density was ranged from 980 to 995 HU. The mean time to complete stone fragmentation (to dust or small fragments) was ranged from 17.11 to 27.2 min. The retropulsion was insignificant in all cases with energy level less than 0.5 J. Authors highlighted that visibility was estimated as optimal by surgeons in most cases. Fragmentation mode with energy level 2 to 5J and repetition rate 5-10 Hz was most suitable for bladder stone disintegration. Overall, the settings of 0.1-0.2J/15-30W; 0.2-0.5J/10-15W and 2-5J/30-50W were identified as optimal for kidney (dusting), ureter (dusting and fragmentation), and bladder (fragmentation) stones, respectively.

Based on the analysis of data, the SuperPulse Tm fiber laser is safe and efficacious for all types of urinary stones in all relevant anatomic locations. Thus, the Super Pulse Tm fiber laser became the alternative to Holmium laser.

Presented by Alim Dymov, Urologist, Sechenov University, Institute for Urology and Reproductive Health, Moscow, Russia. 

Written by: Ekaterina Laukhtina, medical student, Institute for Urology and Reproductive Health, Sechenov University at the 34th European Association of Urology (EAU 2019) #EAU19 conference in Barcelona, Spain from March 15-19, 2019.