Pulsed thulium:YAG (p-Tm:YAG) laser is a novel technology for lithotripsy that seems to be positioned favorably in the middle ground between Ho:YAG laser and thulium fiber laser. This mini review summarizes current evidence regarding p-Tm:YAG physical properties, laboratory results, and clinical outcomes. p-Tm:YAG laser features high peak power, efficient energy use, and a stable pulse profile. In vitro studies have demonstrated effective ablation, minimal retropulsion, and the ability to produce fine stone dust regardless of stone composition. Clinically, flexible ureteroscopy and mini-percutaneous nephrolithotomy using p-Tm:YAG may achieve high stone-free rates and low complication rates. Moreover, comparisons with the other lasers show similar or even better performance in terms of ablation efficiency and operative time. Although these preliminary results are very promising, robust data are needed to validate the versatility of p-Tm:YAG laser for routine use in clinical practice. PATIENT SUMMARY: We summarize current evidence on the new pulsed thulium:YAG laser for the treatment of urinary stones. High stone-free rates and low complication rates have been reported for patients treated for kidney stone disease. Further studies with more patients are needed to establish the superiority of this laser over others.
European urology focus. 2025 Jul 11 [Epub ahead of print]
Cristian Axel Hernandez-Gaytan, Silvia Proietti, Federico De Leonardis, Luca Mongelli, Franco Gaboardi, Guido Giusti
IRCCS Ospedale San Raffaele, Milan, Italy., IRCCS Ospedale San Raffaele, Milan, Italy. Electronic address: .