PURPOSE OF REVIEW: To evaluate emerging evidence and practical applications of thulium-fiber laser (TFL) for genitourinary soft tissue disease and urinary stone disease treatment. RECENT FINDINGS: A systematic review was developed using the PubMed, ScienceDirect, Wiley, SpringerLink and Mary Ann Liebert Scopus databases between 2012 and 2020 years, using the PRISMA statement. We analyzed recent publications including in vitro and in humans outcomes of surgery using TFL. This new laser technology can be used in soft tissue diseases and stones present in the genitourinary system. Most of the comparisons are made with the Ho:YAG laser, using completely different settings. Nevertheless, TFL is safe, feasible and effective in the management of urologic diseases, showing superiority to Ho:YAG even in some studies. SUMMARY: The introduction of pulsed TFL technology has enabled the ablation of stones at rates comparable to or better than currently existing lasers in vitro, while also potentially reducing stone retropulsion. TFL is effective in treating genitourinary soft tissue diseases, including benign prostatic hyperplasia, and early data indicate that it may be effective in the treatment of urinary stone disease. More clinical studies are needed to better understand the indications for this novel technology and clarify its position in the urologic endoscopy armamentarium.

Department of Urology 2nd Faculty of Medicine Charles University Prag Czech Republic

Department of Urology Comprehensive Cancer Center Medical University of Vienna Vienna Austria

Department of Urology University of California Irvine California USA

Department of Urology University of Texas Southwestern Dallas Texas USA

Department of Urology Weill Cornell Medical College New York New York

Division of Urology Department of Special Surgery Jordan University Hospital The University of Jordan Amman Jordan

GRC 20 Lithiase Urinaire Sorbonne University Hôpital Tenon Paris France

Institute for Urology and Reproductive Health Sechenov University Moscow Russia

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A Review of How Lasers Are Used in UTUC Surgery: Can the Choice of Laser Affect Outcomes?