Complications of Diode Laser in Endourological Procedures in Co-morbid Patients

Abstract

Objective: To determine safety of diode laser by studying post operative complications after endourological procedures in co-morbid patients.
Study Design:Adescriptive study.
Place&Duration of Study: Shalamar hospital, Lahore from June 2009 to June 2012.
Materials and Methods: We studied post-operative complications (up to 3 months) in 3 groups (prostatic obstruction, bladder growths ,urethral strictures) of total180 patients with ASA III & IV. We assessed hematuria, UTI, abdominal pain, suprapubic discomfort, urinary retention, dysuria, incomplete procedure, cardiac or respiratory compromise, fluid overload, mortality, catheterization times and mean postoperative hospital stay.
Results: In prostate group, mean age was 70.8±8.6 years and follow-up period was 3 months. Complications were: mild transient haematuria in 65 (100%), creamy urine in 50 (77%), urinary tract infection in 25 (38.4%), dysuria in 16 (24.6%), retreatment required in 06 (9.2%), suprapubic discomfort in 3 (4.5%),TURPsyndrome in 1(1.5%) and significant hemorrhage requiring blood transfusion in 1 (1.5%),. In urethral strictures, the complications were: microscopic hematuria in 80 (100%), urinary tract infection in 52 (65%) suprapubic discomfort in 9 (11.2%), dysuria in 6 (7.4%) mild transient hematuria in 5 (6.2%). In bladder growths, the complications were: mild transient haematuria in 30 (85.7%), creamy urine in 19 (54.2%), suprapubic discomfort in 18 (51.`4%), dysuria in 9 (25.7%), urinary UTI in 8 (22.8%) , ablation performed in two sittings in 1 (2.8%). No mortality in any group.
Conclusion: Diode laser is a safe and useful modality in patients with co-morbidities (ASAIII and IV).