Safety of Thulium Fiber Laser Litothripsy in the Management of Large Renal Stones (>1000 mm³) and Factors Affecting Treatment Success

NCT07153978 | Completed

• 2 other identifiers: 2023/06TF.ALT.23.10
• Study Type: interventional
• Target: 81
• Locations: 1 country
• Sites: 1

Brief Summary

The aim of this study is to compare the efficacy and safety of Thulium Fiber Laser (TFL) litothripsy according to stone density and the factors affecting success in patients undergoing retrograde intrarenal surgery (RIRS) for renal calculi \>1000 mm3. Between November 2023 and December 2024, 81 patients with a stone volume \>1000 mm3 who underwent RIRS with TFL in our clinic were prospectively and sequentially evaluated. Stone density of the patients was measured, and expressed in Hounsfield Units (HU). Patients with stone densities \<1000 HU and ≥1000 HU were categorized as Groups 1, and 2, respectively. Demographic data, data of intraoperative laser use, stone-free rates (SFRs), the need for a second session of RIRS and complications were recorded. Duration of TFL litothripsy, total energy used, laser ablation speed (mm3/sec), laser ablation efficiency (mm3/J) and laser energy consumption (J/mm3) were calculated. Correlation tests, univariate and multivariate logistic regression tests were used for statistical analysis.

Conditions

Renal Stones; Retrograde Intrarenal Surgery; Thulium Fiber Laser

Keywords

Retrograde intrarenal surgery,; Thulium fiber laser; Stone free rate; Kidney stone; Hounsfield Unit.

Outcome Measures

Primary Outcomes (1)

• The primary outcome was to assess the effectiveness of the laser.

  Fragmentation success was used to evaluate the laser effectiveness of laser.

  12 months

Secondary Outcomes (1)

• The secondary outcome was the evaluation of factors affecting stone-free rates

  3 months

Study Arms (1)

Safety and Efficacy of Thulium Fiber Laser for Large Renal Stones

EXPERIMENTAL

Demographic data (age, gender, body mass index (BMI)), stone characteristics (size, location, Hounsfield Unit (HU) value) and durations of the procedures were recorded. Patients over 18 years of age, with kidney stones larger than 1000 mm³, single or multiple stones and those eligible for RIRS were included in the study. Patients under 18 years of age, those with bleeding diathesis or inability to discontinue anticoagulant/antiaggregant therapy, cases with a history of previous RIRS, individuals who did not attend follow-up visits, patients in whom postoperative residual stone assessment could not be made, or had concomitant bladder or ureteral stones were excluded. SFRs, the need for a second session of RIRS and complications were noted. General anesthesia was used. Rigid ureteroscope was inserted through urethral meatus. 11/13 F ureteral sheath was advanced over guidewire under fluoroscopy. Laser settings varied 0.2J/100Hz to 1J/10Hz based on stone fragility.

Device: Effectivity of TFL on large renal stone

Interventions

Effectivity of TFL on large renal stone DEVICE

While literature studies on TFL have focused on the effect of stone size on laser efficacy parameters, the present study is important as it is a prospective study examining the effects of TFL lithotripsy on SFRs in stones \>1000 mm3.

Safety and Efficacy of Thulium Fiber Laser for Large Renal Stones

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Patients ≥18 years of age
• Presence of kidney stones larger than 1000 mm³
• Patients with single or multiple kidney stones
• Patients eligible for retrograde intrarenal surgery (RIRS)

You may not qualify if:

• Patients younger than 18 years
• Pregnant or breastfeeding women
• Patients with uncorrected coagulopathy
• Patients with active urinary tract infection
• Patients with severe anatomic abnormalities preventing RIRS
• Patients unwilling or unable to provide informed consent

Sponsors & Collaborators

• Muharrem Baturu: lead
• University of Gaziantep: collaborator

Study Sites (1)

University of Gaziantep

Gaziantep, Şehitkamil, 27310, Turkey (Türkiye)

Location

MeSH Terms

Conditions

Nephrolithiasis; Kidney Calculi

Condition Hierarchy (Ancestors)

Kidney Diseases; Urologic Diseases; Female Urogenital Diseases; Female Urogenital Diseases and Pregnancy Complications; Urogenital Diseases; Urolithiasis; Male Urogenital Diseases; Urinary Calculi; Calculi; Pathological Conditions, Anatomical; Pathological Conditions, Signs and Symptoms

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: NA
• Masking: NONE
• Purpose: DIAGNOSTIC
• Intervention Model: SINGLE GROUP
• Sponsor Type: OTHER
• Responsible Party: SPONSOR INVESTIGATOR
• PI Title: assistant professor

Study Record Dates

• First Submitted: July 17, 2025
• First Posted: September 4, 2025
• Study Start: November 1, 2023
• Primary Completion: December 1, 2024
• Study Completion: June 1, 2025
• Last Updated: September 4, 2025

Record last verified: 2025-08

Data Sharing

• IPD Sharing: Will share
• Shared Documents: STUDY PROTOCOL, SAP

Locations

TU (1)