It allows for further decrease peak power from the 2000W of the long pulse mode to a value resembling that of TFL (500W), thus generating pulses with longer duration (up to 2000 us compared to the 1100 us of the standard Cyber Ho). When used with Magneto technology, the 150W Cyber Ho generator allows energy range between 0.2 and 2 J and frequency range between 5 and 60 Hz, but maximum power is 32W.1,2 We performed the first comparison between ThuLEP using the Tm: YAG laser and HoLEP using the Cyber Ho generator with Magneto technology.
In our study, patients with surgical indication for BPH underwent Thulium Laser Enucleation of the Prostate (ThuLEP) using Cyber TM generator (Group A) versus “Hybrid” HoLEP using Cyber Ho generator with Magneto technology (Group B). In Group A, settings were 100W for enucleation and 35W for coagulation. In Group B, early apical detachment and coagulation were performed with energy 1 J and frequency 30 Hz by applying Magneto technology. Enucleation was performed with energy 2 J and frequency 40 Hz by applying Virtual Basket pulse modulation.
According to our results, a statistically significant decrease in mean morcellation time (21.2 vs. 14.6 min) and an increase in morcellation efficiency (4.2 vs. 5.8 g/min) were observed in Group B. Postoperative gross haematuria and clots-induced urinary retention were significantly more frequent after ThuLEP. Micturition improvements were comparable.
Our study contributes to providing some clinical data on a brand new technology that has landed in the endourological panorama. The Magneto technology allows for modifying the shape of holmium laser pulses by increasing duration and lowering peak power. Some benefits in terms of better haemostatic control might be expected. Hybrid HoLEP (standard setting with Virtual Basket pulse modulation for enucleation, Magneto technology for coagulation, and early apical release) seems to provide better coagulation compared to ThuLEP, with subsequent improvements in morcellation time, morcellation efficiency, and postoperative complication rate.
Written by: Davide Perri, MD, Division of Urology, Azienda Socio Sanitaria Territoriale Lariana, Sant'Anna Hospital, Como, Italy
References:
- Perri D, Besana U, Mazzoleni F, Maltagliati M, Pacchetti A, Calcagnile T, et al. Mini-percutaneous nephrolithotomy using the new Cyber Ho generator with Magneto technology: the first clinical experience in the treatment of renal stones between 10 and 20 mm. Minerva Urol Nephrol 2025.
- Perri D, Besana U, Mazzoleni F, Maltagliati M, Pacchetti A, Calcagnile T, et al. Cyber Ho generator with Magneto technology: the first experience of a new concept of hybrid HoLEP. Minerva Urol Nephrol 2025.