Current laser therapy options for endoscopic treatment of upper tract urothelial carcinoma

Endoscopic management via retrograde ureteroscopic laser ablation of upper tract urothelial carcinoma (UTUC) has become the preferred treatment modality for low-risk tumors. The most popular ablative lasers over the past 15-20 years have been the holmium:yttrium-aluminum-garnet (Ho:YAG) and neodymium (Nd:YAG) lasers, but recently the thulium (Th:YAG) laser has emerged as a potential alternative. This review compares the mechanism of action, physiological properties and effects, and oncologic outcomes of Ho:YAG/Nd:YAG lasers versus the Th:YAG laser for UTUC treatment. Potential advantages of the Th:YAG laser over existing technologies are outlined, followed by a discussion of emerging laser technologies in UTUC management.

Automated summary

Endoscopic management using retrograde ureteroscopic laser ablation is the preferred treatment for low-risk upper tract urothelial carcinoma (UTUC). Holmium:yttrium-aluminum-garnet (Ho:YAG) and neodymium (Nd:YAG) lasers have been commonly used over the past 15-20 years, but the thulium (Th:YAG) laser has recently emerged as a potential alternative. This review compares the mechanisms, physiological properties, effects, and oncologic outcomes of Ho:YAG/Nd:YAG lasers versus Th:YAG laser for UTUC treatment and discusses emerging laser technologies in UTUC management.