Lasers in urology

A variety of lasers are used in medicine and surgery, and the three most common lasers are argon-ion, carbon dioxide, and Nd:YAG. All three lasers are used in urology because there has been demonstrated efficacy. The genitourinary system is vital to sustain life. The kidneys regulate most of the water in the body. Their main functions are to filter the blood impurities, drain off wastes and maintain the balance of essential chemicals in the body in liquid form. The filtration process is complex but practical. The nurse needs to understand the value of using the laser for a number of urologic procedures. The advantages are decreased blood loss, precision, less damage to surrounding tissue, ability to be used through endoscopes, and possible decreasing length of stay. The patient who presents with renal dysfunction must have an in-depth work-up. Preoperative assessment will include the patient's history, both current and past, laboratory studies, and radiologic examinations. Cystoscopy can be used as part of the work-up and at the same time be used therapeutically. Assessment, planning, implementation, and evaluation do not change significantly from conventional procedures. The instrumentation, equipment, and supplies are the same with the addition of the laser and the various accessories. Laser lithotripsy has been an important adjunct to current therapy. The use of the laser for superficial bladder tumors has decreased the use of Foley catheters and the need to stay in the hospital. Other laser usage for external lesions has also proved to be efficacious. Patients entering the hospital system could benefit from a case management model of care. Case management uses critical paths to standardize managed care, facilitate discharge, promote cost-effective utilization of resources, and encourage collaborative practice, patient satisfaction, and professional satisfaction.