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

ABSTRACT

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 holmiumyttrium-aluminum-garnet (HoYAG) and neodymium (NdYAG) lasers, but recently the thulium (ThYAG) laser has emerged as a potential alternative. This review compares the mechanism of action, physiological properties and effects, and oncologic outcomes of HoYAG/NdYAG lasers versus the ThYAG laser for UTUC treatment. Potential advantages of the ThYAG laser over existing technologies are outlined, followed by a discussion of emerging laser technologies in UTUC management.