{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T06:58:30Z","timestamp":1790405910523,"version":"4.1.0"},"reference-count":22,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T00:00:00Z","timestamp":1782172800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>During ureteroscopic laser lithotripsy (URSL), unsafe elevations in ureteral temperature are thought to contribute to ureteral stricture formation. Cellular damage begins at 43\u00b0C, and proteins denature instantly at 60\u00b0C. Air bubbles may inadvertently migrate into the collecting system during URSL. The purpose of this study was to evaluate ureteral temperatures during simulated URSL in an air bubble with a holmium (Ho:YAG) and thulium fiber laser (TFL).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>BegoStone phantoms were positioned distal to the ureteropelvic junction in a model kidney and ureter submerged in a 35\u00b0C saline bath. A 7.5 Fr flexible ureteroscope was advanced to the stone, and continuous saline irrigation at 22\u00b0C was maintained at 15 mL\/min. A needle thermocouple positioned 2 mm from the laser fiber tip monitored ureteral wall temperature. A 200 \u00b5m laser fiber was then advanced until it contacted the stone. The Ho:YAG and TFL were used in 5 trials each to ablate stones at 3, 10, and 20 W in saline and in a 3 mL air bubble.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      In the control condition, neither laser exceeded 43\u00b0C at 3, 10, or 20 W. In an air bubble, ureteral temperatures exceeded 43\u00b0C after 1 second at 3 W for both TFL and Ho:YAG. At 10 W, the Ho:YAG exceeded 43\u00b0C after 1 second, while the TFL exceeded 60\u00b0C. The average temperature exceeded 60\u00b0C at 20 W for both lasers after 1 second. Both lasers generated much higher temperatures in an air bubble than in saline at all time points (\n                      <jats:italic toggle=\"yes\">p<\/jats:italic>\n                      = 0.008), with maximum temperature exceeding 250\u00b0C for both lasers.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>\n                      In this benchtop model, laser activation in an air bubble for 1 second exceeded the thermal safety threshold at \u2265 3 W and risks protein denaturation at \u2265 20 W. This study highlights the importance of avoiding air bubbles during URSL to maintain safe ureteral temperatures. Further studies are needed to validate these findings\n                      <jats:italic toggle=\"yes\">in\u00a0vivo<\/jats:italic>\n                      .\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08927790261457175","type":"journal-article","created":{"date-parts":[[2026,6,23]],"date-time":"2026-06-23T11:49:57Z","timestamp":1782215397000},"page":"1025-1031","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Bubble Trouble: The Thermal Risk of Ureteral Laser Lithotripsy in an Air Bubble"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1078-1379","authenticated-orcid":false,"given":"Gabriel E.","family":"Martin","sequence":"first","affiliation":[{"name":"Department of Urology, Loma Linda University Health, Loma Linda, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kallan","family":"Richards","sequence":"additional","affiliation":[{"name":"Department of Urology, Loma Linda University Health, Loma Linda, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Jhang","sequence":"additional","affiliation":[{"name":"Department of Urology, Loma Linda University Health, Loma Linda, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adel","family":"Battikha","sequence":"additional","affiliation":[{"name":"Department of Urology, Loma Linda University Health, Loma Linda, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ninous","family":"Betdashtoo","sequence":"additional","affiliation":[{"name":"Department of Urology, Loma Linda University Health, Loma Linda, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jongwan","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Urology, Loma Linda University Health, Loma Linda, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faith","family":"Ajayi","sequence":"additional","affiliation":[{"name":"Department of Urology, Loma Linda University Health, Loma Linda, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhamshid","family":"Okhunov","sequence":"additional","affiliation":[{"name":"Department of Urology, Loma Linda University Health, Loma Linda, California, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D. 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