Lasers and safety in urology

Lasers have become an essential tool in modern urology owing to their versatility and therapeutic efficacy. They are employed in the management of diverse conditions, including urinary stone disease, benign prostatic hyperplasia, urothelial tumors (both upper urinary tract and bladder), urethral and ureteral strictures, as well as ureteropelvic junction obstruction. Despite these undeniable advantages, laser use carries inherent risks. The biological effects of lasers depend on factors such as wavelength, energy settings, tissue absorption, and exposure time, with associated risks varying accordingly. Hence, a comprehensive understanding of optimal laser use is critical for minimizing adverse outcomes.

A narrative review of the literature was performed using the Medline database with the keywords laser, safety, risk*, adverse effects*, complication*, urology. Relevant articles were identified and analyzed to summarize the principal risks associated with laser applications in urology.

Laser use in urology is associated with potential risks affecting patients (thermal injury, ureteral strictures, vascular complications, skin burns), healthcare professionals (ocular, cutaneous, and auditory damage), and equipment (notably ureteroscope damage). Mechanisms of injury and preventive strategies are discussed in this review.

Although the overall risk of adverse events associated with laser use in urology is relatively low for patients, healthcare providers, and equipment, the potential consequences may be significant. A thorough understanding of these risks, together with the implementation of preventive measures, is therefore a fundamental prerequisite for all practicing urologists.