Introduction: Super-Pulse Thulium fiber laser is a novel intracorporeal lithotripter used for management of urinary tract stones. It has several advantages over Holmium-YAG laser including small fibers, lower energy per pulse (up to 0.025 J), and higher maximal pulse repetition rate (up to 2000 Hz). The present study was undertaken to evaluate the efficacy of Super-Pulse Thulium fiber laser in management of lower ureteric stones in Indian population.
Methods: Total 44 patients (age 18 to 60) with lower ureteric stones were included in the study. All patients had undergone semi-rigid ureteroscopy. Super-Pulse Thulium fiber laser with 200ยต fiber was utilized. Settings for fragmentation were kept at 2-6J,5-10Hz, for dusting at 0.2 J to 1J,10-30Hz & for fine dusting at 0.025 to 0.1J , 100-300Hz.
Clearance of the stone, fragmentation time, stone retropulsion & complications were observed.
Results: Out of total 44 patients, the mean age was 40 years (range 19-60). 24 were males & 20 were females. The mean size of the stones was 8.3mm (range 6 to 11mm).The mean HU density of the stones was 842.27 (range 470-1210). The mean fragmentation time was 14min (9min to 23min). Complete clearance was achieved in all cases. There were four cases of sepsis which were managed with intravenous antibiotics without any sequel. No intra-operative complication was noted. There was no incidence of stone retropulsion.
Conclusions: Super-Pulse Thulium fiber laser lithotripsy is promising in endoscopic management of lower ureteric stones. A large randomized controlled study would be required for its extrapolation. Source of
