For pediatric patients undergoing ureteroscopy, the SuperPulsed thulium fiber laser (SPTF) is associated with a higher stone-free rate, with no increase in operative time or complications compared with the low-power holmium:yttrium-aluminum-garnet (Ho:YAG) laser, according to a study published in The Journal of Urology. Christopher Jaeger, MD, and colleagues conducted a retrospective, consecutive cohort study of unilateral ureteroscopy with laser lithotripsy performed in pediatric patients during 2016-2021, analyzing 30-day complications and stone-free status. Among 125 cases performed in 109 pediatric patients, 93 were done with Ho:YAG and 32 with SPTF. The overall stone-free rate was 62%: 70% with SPTF and 59% with Ho:YAG. Compared with Ho:YAG, the odds of having a residual stone fragment were significantly lower with SPTF (OR, 0.39). There were seven complications (25%) with SPTF and 19 (22%) with Ho:YAG. “The SPTF laser using thulium fiber laser technology is an effective alternative to the low-power Ho:YAG laser for treatment of urolithiasis in pediatric patients,” Dr. Jaeger and colleagues wrote.