PMID- 24074324
OWN - NLM
STAT- MEDLINE
DCOM- 20140509
LR  - 20190318
IS  - 1557-900X (Electronic)
IS  - 0892-7790 (Linking)
VI  - 28
IP  - 2
DP  - 2014 Feb
TI  - Adverse events resulting from lasers used in urology.
PG  - 256-60
LID - 10.1089/end.2013.0451 [doi]
AB  - OBJECTIVE: To collate world reports of adverse events (AEs) resulting from lasers 
      used in urology. METHODS: The Manufacturer and User Facility Device Experience 
      (MAUDE) database of the United States Food and Drug Administration (FDA) was 
      searched using the term "Laser for gastro-urology use." In addition, the Rockwell 
      Laser Industries (RLI) Laser Accident Database was searched for the following 
      types of lasers: neodymium-doped yttrium aluminum garnet (Nd:YAG), 
      holmium:yttrium aluminum garnet (Ho:YAG), potassium titanyl phosphate (KTP), 
      diode and thulium:YAG (Tm:YAG). RESULTS: Both databases were last accessed on 
      October 1, 2012. Overall, there were 433 AEs; 166 in MAUDE database (1992-2012) 
      and 267 in RLI database (1964-2005). Most of the AEs (198/433 or 46%) resulted 
      from generator failure or fiber tip breaking. Whereas there were 20 (4.6%) AEs 
      harming medical operators, there were 159 (37%) AEs harming nonmedical operators 
      using Nd:YAG, KTP, and diode lasers. Eye injuries ranging from mild corneal 
      abrasions to total vision loss were reported in 164 AEs with the use of Nd:YAG, 
      KTP, and diode lasers. Overall, there were 36 (8.3%) AEs resulting in patient 
      harm, including 7 (1.6%) mortalities, 3 deaths from ureteral perforation using 
      the Ho:YAG laser, and 4 deaths from air emboli using the Nd:YAG laser. Other 
      reported patient injuries included bladder perforation resulting in urinary 
      diversion in a patient, in addition to minor skin burns, internal burns, and 
      bleeding in others. There were no AEs reported with the use of Tm:YAG laser. 
      CONCLUSIONS: Most of the AEs reported relate to equipment failure. There were no 
      eye injuries reported with the use of Ho:YAG lasers. Caution must be exercised 
      when using lasers in urology, including wearing appropriate eye protection when 
      using Nd:YAG, KTP, and diode lasers.
FAU - Althunayan, Abdulaziz M
AU  - Althunayan AM
AD  - Division of Urology, Department of Surgery, McGill University Health Center, 
      McGill University, Montreal, Quebec, Canada.
FAU - Elkoushy, Mohamed A
AU  - Elkoushy MA
AD  - Division of Urology, Department of Surgery, McGill University Health Center, 
      McGill University, Montreal, Quebec, Canada; Department of Urology, Suez Canal 
      University, Ismailia, Egypt
FAU - Elhilali, Mostafa M
AU  - Elhilali MM
FAU - Andonian, Sero
AU  - Andonian S
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20131119
PL  - United States
TA  - J Endourol
JT  - Journal of endourology
JID - 8807503
RN  - 0 (yttrium-aluminum-garnet)
RN  - 58784XQC3Y (Yttrium)
RN  - CPD4NFA903 (Aluminum)
SB  - IM
CIN - J Urol. 2015 Jan;193(1):170. PMID: 25523666
MH  - Aluminum/*adverse effects
MH  - Eye Protective Devices
MH  - Humans
MH  - Laser Therapy/*adverse effects/instrumentation
MH  - Lasers, Semiconductor/*adverse effects
MH  - Lasers, Solid-State/*adverse effects
MH  - Postoperative Complications/*etiology
MH  - Treatment Outcome
MH  - Urologic Diseases/*complications/surgery
MH  - Yttrium/*adverse effects
EDAT- 2013/10/01 06:00
MHDA- 2014/05/10 06:00
CRDT- 2013/10/01 06:00
PHST- 2013/10/01 06:00 [entrez]
PHST- 2013/10/01 06:00 [pubmed]
PHST- 2014/05/10 06:00 [medline]
AID - 10.1089/end.2013.0451 [doi]
PST - ppublish
SO  - J Endourol. 2014 Feb;28(2):256-60. doi: 10.1089/end.2013.0451. Epub 2013 Nov 19.