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Evaluation of noise hazard during the holmium laser enucleation of prostate

BMC Urology Sep 15, 2017

Xu H, et al. - Researchers evaluated noise hazard during holmium laser enucleation of the prostate (HoLEP) to detect such a risk in this procedure. It was demonstrated that the noise level during HoLEP is within hearing conservation levels. Nevertheless, the noise disturbs intrateam communication and concentration during surgery. Moreover, some surgeons may experience discomfort post-surgically, but no significant difference among the groups is indicated. The outcomes reveal that measures should be taken to address the noise caused by the laser emitter during holmium laser enucleation of the prostate.

Methods
  • This work was carried out over a 12-month period on 223 patients with benign prostatic hyperplasia (BPH), 121 of whom underwent HoLEP while those remaining underwent transurethral resection of the prostate (TURP).
  • They applied a sound level meter to detect the exposure of surgeons to noise.
  • Moreover, the recordings used were in accordance with the standards set by the Occupational Safety and Health Administration (OSHA) and the United States Environmental Protection Agency.
  • For this study, each of the 43 surgeons participating in a BPH discussion conference answered the questionnaire on the influence of noise, and 33 surgeons in the department volunteered for blood pressure monitoring post-surgically.

Results
  • The sound level produced by a high-powered holmium laser emitter during HoLEP was 67.37 ± 0.13 dB, which was significantly higher than the sound heard during TURP (46.41 ± 0.29 dB, P < 0.01).
  • They observed that the 65–70 dB noise during HoLEP was a safe level in accordance with the OSHA standards.
  • Nevertheless, this level was considerably greater than the stated 55 dB.
  • Furthermore, it exceeded the normal communication protective level of 60 dB.
  • In the analysis of responses from the surgeons, they demonstrated that the HoLEP group obtained an average score that reflected disturbance caused by the laser emitter and an increase in average systolic pressure relative to that in the TURP group.
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