{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:52:05Z","timestamp":1791564725483,"version":"4.3.4"},"reference-count":16,"publisher":"S. Karger AG","license":[{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/karger.com\/pages\/terms-and-conditions"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Urol Int"],"abstract":"<jats:p>Introduction: The objective of this study was to compare the efficacy and clinical outcomes of ureteroscopic lithotripsy using the holmium:YAG laser (Ho:YAG) and pulsed thulium:YAG laser (p-Tm:YAG: RevoLix HTL, LISA Laser Products, Germany) for upper urinary tract stones. Methods: This retrospective single-center study included patients who underwent ureteroscopy for kidney or ureteral stones between August 2023 and August 2025. Patients with bilateral stones, concomitant procedures, stones \u226520 mm, or without preoperative computed tomography imaging were excluded. Endpoints included operative time, laser efficacy (ratio of cumulative stone volume to operative time), and the stone-free rate (SFR). Results: We analyzed 104 patients (Ho:YAG, n = 54; p-Tm:YAG, n = 50). The p-Tm:YAG group exhibited significantly shorter operative time (46.0 vs. 66.5 min, p &lt; 0.001) and higher laser efficacy (0.237 vs. 0.175 mm3\/min, p = 0.016). Subgroup analysis revealed that p-Tm:YAG exhibited significantly shorter operative times (49.0 vs. 96.0 min, p &lt; 0.001) and superior laser efficacy (0.252 vs. 0.183 mm3\/min, p = 0.008) for stones measuring 10\u201320 mm, whereas similar outcomes were observed for stones &lt;10 mm between the two groups. The Ho:YAG and p-Tm:YAG groups exhibited similar SFRs on postoperative day 1 (79.6% vs. 88.0%, p = 0.182) and at 1 month (87.0% vs. 92.0%, p = 0.325). Conclusion: Both lasers achieved comparable and high SFRs for stones &lt;20 mm. However, the p-Tm:YAG laser offers higher laser efficacy and significantly shorter operative times, particularly for larger stones (10\u201320 mm), supporting its use as an efficient alternative to the Ho:YAG laser.<\/jats:p>","DOI":"10.1159\/uin\/aewag005","type":"journal-article","created":{"date-parts":[[2026,9,18]],"date-time":"2026-09-18T18:26:07Z","timestamp":1789755967000},"page":"1-1","source":"Crossref","is-referenced-by-count":0,"title":["Comparative Laser Efficacy and Clinical Outcomes of Pulsed Thulium:YAG versus Standard Holmium:YAG Lithotripsy"],"prefix":"10.1159","author":[{"given":"Yusuke","family":"Shirasu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takashi","family":"Yoshida","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaro","family":"Oku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shogo","family":"Murakami","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gen","family":"Kawa","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2026,10,1]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2022.06.014"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-014-1395-1"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3389\/fsurg.2017.00057"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016\/j.eururo.2022.02.027"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-023-04549-y"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1111\/iju.15548"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2023.10.004"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1038\/nrurol.2015.74"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000133083.54934.ae"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1038\/bmt.2012.244"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-023-04651-1"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.euros.2024.07.114"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-023-04501-0"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-025-06001-9"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2025.01.065"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s00345-018-2455-8"}],"container-title":["Urologia Internationalis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/karger.com\/article-pdf\/doi\/10.1159\/uin\/aewag005","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,10,9]],"date-time":"2026-10-09T16:02:12Z","timestamp":1791561732000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/uin\/aewag005"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,10,1]]},"references-count":16,"URL":"https:\/\/doi.org\/10.1159\/uin\/aewag005","archive":["Portico"],"relation":{},"ISSN":["0042-1138","1423-0399"],"issn-type":[{"value":"0042-1138","type":"print"},{"value":"1423-0399","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,10,1]]}}}