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The following is a summary of “High-frequency in laser lithotripsy: do we truly know what it means?,” published in the May 2025 issue of World Journal of Urology by Bravo-Balado et al. 

Researchers conducted a retrospective study to assess existing literature on the definitions of high frequency (HF) in laser lithotripsy and its implications for clinical outcomes and patient safety.   

They executed a comprehensive search of MEDLINE, Scopus, and Cochrane databases for English-language studies published up to November 2024, including those referencing HF in Holmium:YAG (Ho:YAG), Thulium Fiber Laser (TFL), and pulsed Thulium:YAG (p-Tm:YAG) used in ureteral and renal endoscopic procedures and also included in vitro studies, reviews, editorials, laser manufacturer manuals, and data from artificial intelligence (AI) platforms.   

The results showed that from 1,030 initial records, 857 were screened and 106 studies were included, with most from Europe (N=46), North America (N=37) and HF was poorly defined in 25 studies—Europe (N=11), North America (N=7). Most studies examined Ho:YAG (N=80), followed by TFL (N=13), and pulsed p-Tm:YAG (N=1), with others assessing combinations. The HF definitions ranged from 10–200 Hz in Europe and 10–120 Hz in North America, averaging 40–50 Hz. Only 4 of 8 manufacturers provided HF definitions in pre-settings, the AI platforms defined HF as 15–100 Hz for Ho:YAG, 50–2000 Hz for TFL, and 20–500 Hz for p-Tm:YAG.   

Investigators concluded that the lack of consensus on HF definitions in laser lithotripsy emphasized the need for standardized terminology, with suggested thresholds of > 30 Hz for renal and > 15 Hz for ureteral procedures. 

Source: link.springer.com/article/10.1007/s00345-025-05650-0