What Is Moses Effect: A Historical Perspective

Introduction and Objectives: The Moses effect (ME) was described >30 years ago during normal laser functioning in a fluid medium. Recently, a laser device equipped with a pulse-modulating system called Moses (TM) technology (MT; Lumenis) was marketed for both stone lithotripsy and prostate endoscopic surgery. We aimed to perform a literature revision of ME from a historical perspective up until its present-day applications. Evidence Acquisition: A search of Medline, PubMed, and Scopus was performed to identify articles published in English within the past 30 years addressing both ME and MT in relation to their urologic applications. Relevant studies were then screened, and the data were extracted, analyzed, and summarized. The preferred reporting items for systematic reviews and meta-analysis criteria were applied. Results: ME was first described in 1986 during endovascular laser tissue ablation. During the late 1980s and the early 1990s, the interest raised around ME led to its characterization and better definition. Despite this initial interest, ME gradually disappeared from the focus of researchers and clinicians. In 2017, MT was launched on the market, although postmarketing comparative efficacy and safety data are lacking. Conclusions: Although ME had been described and characterized during normal laser functioning >30 years ago, only very recently it began to regain some consideration after the marketing of MT, whose clinical outcomes are still awaited.