A review of the Moses effect and its applications in endourology

The holmium:yttrium aluminum garnet laser, the gold standard for lithotripsy, is widely used in various endourological fields. Their physical characteristics contribute to the Moses effect. This narrative review aimed to analyze the current knowledge of the Moses effect and its applications in endou...

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Bibliographic Details
Authors: Piñero, Adrià, Narváez, Alonso, Placer, José, Miret Alomar, Enric|||0000-0002-6656-5050, Trilla Herrera, Enrique|||0000-0001-9401-0872, Morote Robles, Juan|||0000-0002-2168-323X
Format: article
Publication Date:2024
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:dnet:uabarcelona_::6f03cac9234b49ba5df9097b542e7c85
Online Access:https://ddd.uab.cat/record/327173
https://dx.doi.org/urn:doi:10.1097/CU9.0000000000000239
Access Level:Open access
Keyword:Moses effect
Holmium:yttrium aluminum garnet
Lithotripsy
Benign prostatic hyperplasia
Holmium laser enucleation of the prostate
Description
Summary:The holmium:yttrium aluminum garnet laser, the gold standard for lithotripsy, is widely used in various endourological fields. Their physical characteristics contribute to the Moses effect. This narrative review aimed to analyze the current knowledge of the Moses effect and its applications in endourology. The Moses effect involves the rapid formation of a vapor bubble that allows the remaining energy to reach the target with less attenuation. Lumenis® developed pulse modulation technology, the MOSES™ technology, that harnesses the Moses effect to optimize holmium energy. Preclinical studies concluded that the new technology improves stone retropulsion, allowing for reduced lithotripsy duration. However, the heterogeneity of clinical studies and the lack of randomized controlled trials do not allow definitive conclusions. The MOSES™ technology has also been applied in holmium laser enucleation of the prostate, reducing enucleation and hemostasis times, leading to improved enucleation efficiency. However, minimal changes occurred in hemoglobin or hematocrit levels and no significant differences were noted in complications or functional outcomes. Further research is needed to fully evaluate the benefits and limitations of MOSES™ technology in clinical practice.