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Related Concept Videos

Urinary Tract Calculi VI: Surgical Management01:25

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Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
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Meaning of Cystoscopic Examination:Cystoscopy is an essential diagnostic tool in urology that is used to assess the structure and function of the genitourinary system. It provides a direct view of the urethra, bladder, and, in some cases, the ureteral openings. This procedure helps detect structural abnormalities, infections, cancers, and blockages in the urinary tract. There are two types of cystoscopy:Flexible cystoscopy is commonly performed in outpatient settings due to its less invasive...
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IntroductionIntravenous Urography (IVU) and Retrograde Pyelography (RP) are important diagnostic imaging techniques used to evaluate the urinary system. These methods help identify structural abnormalities, obstructions, and functional issues in the kidneys, ureters, and bladder. Both procedures use iodine-based contrast media to enhance the visibility of urinary tract structures on X-ray images, though they differ in their methods and indications.1. Intravenous Urography (IVU)Intravenous...
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Related Experiment Video

Updated: Jan 10, 2026

Photoselective Vaporesection of the Prostate via an End-firing Lithium Triborate Crystal Laser
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Laser applications in endourology: Percutaneous nephrolithotomy.

Christophe Almeras1, Frédéric Panthier2, Steeve Doizi3

  • 1URoSud, Clinique la Croix du Sud, Quint-Fonsegrives, France.

The French Journal of Urology
|November 23, 2025
PubMed
Summary

Mini-percutaneous nephrolithotomy (PCNL) offers a less invasive option for kidney stones. The Holmium:YAG laser is standard, but Thulium Fiber Lasers show promise for improved efficiency and cost-effectiveness in complex cases.

Keywords:
Calculs rénauxKidney stonesLaserLithotripsieLithotripsyNéphrolithotomie percutanéePercutaneous nephrolithotomy

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Area of Science:

  • Urology
  • Minimally Invasive Surgery
  • Laser Lithotripsy

Background:

  • Percutaneous nephrolithotomy (PCNL) is the standard for large kidney stones (>2cm).
  • Mini-PCNL reduces morbidity with comparable success rates, especially with laser lithotripsy.
  • Endoscopic Combined Intra-Renal Surgery (ECIRS) combines PCNL with flexible ureteroscopy (FURS) for complex stones.

Purpose of the Study:

  • To review laser technologies for mini-PCNL and ECIRS.
  • To compare Holmium:YAG (Ho:YAG) laser with emerging Thulium Fiber Laser (TFL) and pulsed Thulium:YAG lasers.

Main Methods:

  • Review of current literature on laser lithotripsy in mini-PCNL and ECIRS.
  • Discussion of laser parameters, fiber optics, and technological advancements.
  • Comparison of Ho:YAG, TFL, and pulsed Thulium:YAG laser systems.

Main Results:

  • Ho:YAG laser with 500μm fibers and high power (>30W) is effective in mini-PCNL, utilizing retropulsion and Venturi effect.
  • TFL with smaller 200μm fibers offers stability and cost benefits for ECIRS.
  • Limited data exists for TFL in mini-PCNL; pulsed Thulium:YAG shows potential but requires further study.

Conclusions:

  • Ho:YAG laser remains the reference for mini-PCNL.
  • TFL presents a promising alternative for ECIRS, offering cost and efficiency advantages.
  • Further research is needed to establish the role of TFL and pulsed Thulium:YAG in mini-PCNL.