Laser Treatments for Kidney Stones
What You Need to Know Before You Apply
What is the purpose of this trial?
This trial compares two types of laser technology for treating kidney stones during ureteroscopy. Researchers aim to determine which laser more effectively and safely breaks up kidney stones. The trial will test a pulsed Thulium:YAG laser against a pulse-modulated Holmium:YAG laser (also known as the Moses Holmium:YAG laser). Individuals with a single kidney stone or multiple stones totaling 7-20 mm in size, who qualify for ureteroscopy, may be suitable for this study. As an unphased trial, it offers participants the chance to contribute to advancing medical knowledge and improving future kidney stone treatments.
Will I have to stop taking my current medications?
The trial information does not specify whether you need to stop taking your current medications. It's best to discuss this with the study team or your doctor.
What prior data suggests that these laser technologies are safe for kidney stone treatment?
Research has shown that both the pulsed Thulium:YAG laser and the pulse-modulated Holmium:YAG laser, used to break kidney stones, are generally safe for patients. Studies have found that the pulsed Thulium:YAG laser is well-tolerated, achieving high success rates in stone removal with few complications. Patients often experience effective stone removal with minimal side effects.
Similarly, studies report that the pulse-modulated Holmium:YAG laser is effective and safe, with no major differences in success rates or complications compared to other methods. It also tends to use less energy, potentially resulting in fewer side effects.
Both laser treatments have been frequently used and have demonstrated good safety records in previous research, suggesting they are reliable options for treating kidney stones.12345Why are researchers excited about this trial's treatments?
Researchers are excited about these laser treatments for kidney stones because they offer potentially more effective and precise options compared to traditional methods. The Pulsed Thulium:YAG laser and the Pulse-modulated Holmium:YAG laser are designed to break down stones with greater efficiency and minimal damage to surrounding tissues. These lasers utilize advanced pulse modulation techniques, which could lead to quicker procedures and faster recovery times for patients. This represents a significant improvement over conventional treatments like extracorporeal shock wave lithotripsy (ESWL) and older laser technologies, offering hope for better patient outcomes.
What evidence suggests that this trial's laser treatments could be effective for kidney stones?
This trial will compare the effectiveness of the pulsed Thulium:YAG laser and the pulse-modulated Holmium:YAG laser for treating kidney stones. Research has shown that both lasers are effective. Studies indicate that the Thulium:YAG laser often leaves more patients completely free of stone fragments compared to the Holmium:YAG laser. For instance, one study found that the Thulium laser achieved a stone-free rate of 88.2% for small fragments, while the Holmium laser had a rate of 78.6%. Additionally, the Thulium laser usually works faster, reducing the time needed to break up larger stones by 40%. However, both lasers are generally effective, and neither shows a significant advantage over the other for certain types of stones. Participants in this trial will receive either the Thulium:YAG laser or the Holmium:YAG laser during their procedure.14678
Who Is on the Research Team?
Esteban Emiliani, MD, PhD
Principal Investigator
NYU Langone Health
Are You a Good Fit for This Trial?
This trial is for adults (18+) with kidney stones between 7-20 mm who are eligible for flexible ureteroscopy. Participants must be able to give consent and not have untreated urinary infections, prior abdominal/pelvic radiation, certain anatomical abnormalities, or a history of specific urinary tract surgeries.Inclusion Criteria
Exclusion Criteria
Timeline for a Trial Participant
Screening
Participants are screened for eligibility to participate in the trial
Treatment
Participants undergo ureteroscopy using either the Pulsed Thulium:YAG laser or the pulse-modulated Holmium:YAG laser for kidney stone treatment
Follow-up
Participants are monitored for stone-free rate and other secondary endpoints postoperatively
What Are the Treatments Tested in This Trial?
Interventions
- Moses Holmium:YAG laser
- Thulium:YAG laser
Trial Overview
The study compares two types of lasers—pulsed Thulium:YAG and pulse-modulated Holmium:YAG (Moses technology)—used during surgery to break up kidney stones. The goal is to see which laser works better and more safely when used with FANS access sheaths.
How Is the Trial Designed?
2
Treatment groups
Experimental Treatment
Flexible Ureterorenoscopy (URS) for kidney stone treatment will be performed per standard medical care, and surgeons will use the Pulsed Thulium:YAG laser during the procedure.
Flexible Ureterorenoscopy (URS) will be performed using standard techniques without deviation from routine care, and surgeons will use the pulse-modulated Holmium:YAG laser during the procedure.
Find a Clinic Near You
Who Is Running the Clinical Trial?
NYU Langone Health
Lead Sponsor
Citations
YAG laser for ureteral and renal stones: a multicenter ... - PMC
For stones > 20 mm, SP-TFL reduced lithotripsy time by 40% compared to Ho: YAG (P < 0.001), likely due to its optimized energy delivery and ...
MULTICENTER RANDOMIZED TRIAL COMPARING ...
Both lasers are effective and efficient at treating renal stones for outpatient ureteroscopy of stones ≤ 2 cm. Surgeon and institutional ...
Next-Generation Moses Pulse Modulation: An Evaluation of ...
This characteristic makes the holmium YAG laser particularly effective in tissues with high water content, such as kidney stones and prostate ...
4.
urology.wisc.edu
urology.wisc.edu/wp-content/uploads/2023/01/JU.YAG-vs-Thulium-for-renal-and-ureteral-stones.pdfPulse-modulated Holmium:YAG Laser vs the Thulium Fiber ...
Secondary outcomes were stone-free rate, complications, subjective surgeon measurement of laser performance, patient related stone quality of ...
5.
wolterskluwer.com
wolterskluwer.com/en/news/tfl-has-similar-effectiveness-to-modern-high-power-pulse-modulated-laser-for-kidney-stone-treatmentTFL has similar effectiveness to modern pulse modulated ...
The new study shows TFL has no significant clinical advantage over a modern high-power pulse modulated holmium-yttrium aluminum garnet (Ho:YAG) laser in ...
Pulse-modulated Holmium:YAG Laser vs the Thulium Fiber ...
The pulse-modulated Ho:YAG laser did have reduced total energy usage and improved ablation efficiency when compared to the TFL; however, the ...
Comparison of the efficacy and safety of holmium laser ... - PMC
MOSES mode holmium laser was superior to the regular mode laser in terms of procedure time. There was no large disparity in stone-free rates or complications.
Next-Generation Moses Pulse Modulation: An Evaluation ...
This characteristic makes the holmium YAG laser particularly effective in tissues with high water content, such as kidney stones and prostate ...
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