Adoption of thulium fiber laser for lithotripsy

A scoping review and bibliometric analysis

Authors

  • Ihtisham Ahmad Temerty Faculty of Medicine, University of Toronto
  • Priyank Yadav Sanjay Gandhi Postgraduate Institute of Medical Sciences
  • Rahim Dhalla Western University
  • Anna-Lisa Nguyen Western University
  • Adam Bobrowski University of Toronto
  • David-Dan Nguyen University of Toronto
  • Jason Y. Lee University of Toronto
  • Michael E. Chua Sickkids

DOI:

https://doi.org/10.5489/cuaj.9500

Keywords:

ureteroscopy, laser, Thulium, Ho:YAG, PCNL

Abstract

Introduction: While Holmium:YAG for laser lithotripsy remains the gold standard, the thulium fibre laser (TFL) has gained traction as a tool in urolithiasis management. The objective of this study was to review its adoption and use as a clinically effective laser lithotrite.

Methods: We performed a scoping review for articles on TFL for lithotripsy according to Preferred Reporting Items for Systematic reviews and Meta-Analyses Extension for Scoping Reviews (PRISMA-ScR). Available clinical outcomes and pre-clinical processes from studies were extracted. A bibliometric analysis was performed to outline and visualize publication trends overall and between clinical vs. pre-clinical studies. The review was registered in the International Prospective Register of Systematic Review (CRD42022300788).

Results: We identified a total of 107 studies using TFL for lithotripsy, 38 of which were clinical including 2803 patients, and 69 pre-clinical. Of the clinical studies, 26 (68%) were prospective and 29 (76%) involved ureteroscopic management of stones compared to 11 (29%) percutaneous nephrolithotomy. Complications rates remained acceptable between 032% and stone-free rates varied from 61100%. Tissue damage from TFL varied from 08%. Bibliometric analyses showed a rise in publications after 2020 in both clinical and pre-clinical work, with the U.S. (34%) then Russia (12%) as the leading countries, and the Journal of Endourology (24%) then World Journal of Urology (23%) being the leading venues.

Conclusions: By unifying clinical outcomes and pre-clinical insights, this review showed the maturation of TFL into an effective, versatile lithotripsy modality with accelerating global uptake. Further evidence is required to better characterize remaining clinical variability, lack of standardized outcome definitions, and cost-effectiveness analyses.

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Author Biographies

Anna-Lisa Nguyen, Western University

None. 

Adam Bobrowski, University of Toronto

None.

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Published

2026-03-16

How to Cite

Ahmad, I., Yadav, P., Dhalla, R., Nguyen, A.-L., Bobrowski, A., Nguyen, D.-D., … Chua, M. E. (2026). Adoption of thulium fiber laser for lithotripsy: A scoping review and bibliometric analysis. Canadian Urological Association Journal, 20(7). https://doi.org/10.5489/cuaj.9500

Issue

Vol. 20 No. 7 (2026): CUAJ July

Section

Review

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