Clinical Study on the Treatment of Paravesical Cysts Combined with Renal Calculi using ureteroscopy with super-pulsed thulium fiber laser

Abstract Objective To investigate the safety and feasibility of super-pulsed thulium fiber laser under transurethral flexible ureteroscopy in the treatment of parapelvic cysts combined with renal stones. Patients and methods Twelve patients with parapelvic cysts combined with renal stones admitted from October 2022 to May 2023 were treated with super-pulsed thulium fiber laser under transurethral flexible ureteroscopy and internal incision and drainage simultaneously. CT scans were performed at 1, 3, and 6 months postoperative to assess the cysts and stones, respectively. Results The mean age of the patients was 61.5 ± 7.5 years. The mean size of parapelvic cysts was 5.6 ± 0.7 cm. The mean size of the renal stones was 15.6 ± 3.2 mm. The mean CT density of all stones was 1,464.9 ± 656.5 HU. All patients underwent successful one-stage surgery without serious complications. The mean operative time was 41.2 ± 9.5 min. The average intraoperative bleeding was 6.7 ± 3.0 mL, and the average hospital stay was 2.0 ± 0.7 d. The postoperative CT reexamination indicated that the stone clearance rate was 100%, with no obvious residual stone, and the parapelvic cysts basically disappeared. Conclusion Super-pulsed thulium fiber laser under transurethral flexible ureteroscopy is a safe, feasible, and effective treatment method for parapelvic cysts combined with renal stones, with the advantages of high stone clearance rates and low intraoperative bleeding.