Efficacy and Safety of Thulium Fiber Laser for Renal Stone: A Cross Sectional Study

Abstract

Introduction: Renal stone disease is a common urological condition associated with increasing morbidity and healthcare burden worldwide. Retrograde intrarenal surgery using laser lithotripsy has become an established minimally invasive treatment option for renal calculi. Recently, Thulium fiber laser has emerged as a promising laser technique because of its superior stone ablation efficiency, reduced retropulsion, finer stone dusting, and minimal tissue penetration.

Aims: To evaluate the efficacy and safety  of Thulium Fiber lithotripsy in patients undergoing retrograde intrarenal surgery for renal stones.

Methods: This prospective cross-sectional study was conducted in the Department of Urology, Nepalgunj Medical College, from February 2026 to April 2026. A total of 38 patients with renal stones measuring 10-20 mm were included. All patients underwent retrograde intrarenal surgery with thulium fiber laser. Operative outcomes, stone clearance, and postoperative complications were recorded and analyzed.

Results: Among 38 patients, 22 (57.9%) were females and 16 (42.1%) were males. The mean stone size was 15.3 ± 2.9 mm. The mean operative time was 60.6 ± 22.4 minutes, and the mean hospital stay was 2.5 ± 1.0 days. Stone-free status was achieved in 36 patients (94.7%). Postoperative complications included fever in 13.2%, hematuria in 7.9%, and urinary tract infection in 5.3% of patients. No major complications or mortality were observed.

Conclusion: Thulium fiber laser lithotripsy is a safe and effective minimally invasive treatment modality for renal stones, demonstrating high stone clearance rates with acceptable operative outcomes and minimal complications.