Care associated adverse events related to the use of laser in urological interventions: the French experience

Maher Abdessater ^1* Frederic Panthier ¹ Philippe Michel ² Vanessa Avrillon ¹ Bertrand Pogu ¹ Stephane Bart ¹

• ¹ French Association of Urology, Paris, France
• ² Pontoise Hospital Center, Faculté de Médecine, Université Paris Cité, Pontoise, France

The use of laser in urology is increasing, especially in renal stones and benign prostatic hypertrophy. Despite the interest of this technology in improving surgical management, several adverse events may result. This work collates French reports of care associated adverse events (CAE) resulting from lasers used in urological interventions.This is the collection of CAE between May 2016 and December 2023 declared by urologists involved in accreditation throughout France. These CAEs were classified according to 5 levels of severity. They have been described and classified according to ALARM protocol. The statistics were mainly descriptive. Fisher's exact test and Student's test were used via the software R.Between May 2016 and December 2023, between the 1376 declared events, 149 laser related CAEs were reported in urological interventions. Five CAEs (3.4%) were classified as grade 3, and 6 CAEs (4%) as grade 4. All other CAEs were between grade 1 and 2 with negligible consequences. The laser AEs' immediate reported causes were: the clinical complexity of the case (7.38%), the technical gesture (14.1%), patient information (24.83%), material (38.25%), and medications (15.43%). Incidents caused by materiel problems seem to be more frequent in younger patients (p<0.001), healthier patients (ASA 1) (P=0.003), risky situations (p<0.001) and laser procedures (p<0.001).In France, 7.4% of CAEs related to the use of laser in urological surgery are of major to critical severity. Training teams to the use of laser generators and feedback on functional results and related specific morbidity seems necessary to guarantee the proper use of these technologies, and the safety of staff and patients.