Karaaslan Mustafa, Yilmaz Mehmet, Ordu Melike, Sirin Mehmet Emin
Urology, Bayındır Kavaklidere Hospital, Ankara, TUR.
Urology, Asklepios Klinik Triberg, Triberg, DEU.
Cureus. 2023 Sep 14;15(9):e45234. doi: 10.7759/cureus.45234. eCollection 2023 Sep.
Introduction We aimed to observe the effects of holmium:yttrium-aluminum-garnet (Ho:YAG) laser on testicular tissue. Methods An ex vivo experiment was conducted using calf testicles. A 100 W laser generator with broad-spectrum settings of 10-80 W, 20-40 Hz, and 0.5-2 J, with a medium pulse duration, was tested. The laser effects on testicular tissues with and without the tunica layer were evaluated histopathologically by calculating the incision depth (ID), vaporization area (VA), coagulation area (CA), and total laser area (TLA=VA+CA) of the specimens. Results A total of 48 experiments were conducted. In testicular tissue without a tunica layer, the highest mean ID was determined at 1 J-20 Hz (0.247±0.0208 mm) and with a tunica layer at 2 J-40 Hz (2.673±0.032 mm). In the testicular tissue without a tunica layer, the highest mean VA was determined at 1.5 J-40 Hz (0.029±0.0016 mm) and in tissue with a tunica at 2 J-40 Hz (6.173±0.114 mm). The highest mean TLA in tissue without a tunica was detected at 2 J-20 Hz (0.038±0.0008 mm) and in tissue with a tunica at 2 J-40 Hz (7.292±0.07 mm). The mean ID, VA, CA, and TLA values of all the power outputs used were found to be statistically significantly higher in the testicular tissue with the tunica layer than in that without it (p<0.001). Conclusion The Ho:YAG laser has different effects on testicular tissue with and without a tunica layer. In testicular tissue without a tunica, the laser's effect was minimal on the surrounding tissue, especially in terms of the ID, VA, and TLA. This minimal effect of the laser can be an advantage in testicular surgery procedures such as testis-sparing surgery (TSS) or testicular sperm extraction (TESE).
引言 我们旨在观察钬:钇铝石榴石（Ho:YAG）激光对睾丸组织的影响。方法 使用小牛睾丸进行体外实验。测试了一台100W激光发生器，其具有10 - 80W、20 - 40Hz和0.5 - 2J的广谱设置，脉冲持续时间为中等。通过计算标本的切口深度（ID）、汽化面积（VA）、凝固面积（CA）和总激光面积（TLA = VA + CA），对有无白膜层的睾丸组织的激光效应进行组织病理学评估。结果 共进行了48次实验。在没有白膜层的睾丸组织中，最高平均ID在1J - 20Hz时测定为（0.247±0.0208mm），有白膜层时在2J - 40Hz时测定为（2.673±0.032mm）。在没有白膜层的睾丸组织中，最高平均VA在1.5J - 40Hz时测定为（0.029±0.0016mm），有白膜层的组织在2J - 40Hz时测定为（6.173±0.114mm）。没有白膜层的组织中最高平均TLA在2J - 20Hz时检测到为（0.038±0.0008mm），有白膜层的组织在2J - 40Hz时为（7.292±0.07mm）。发现所有使用的功率输出的平均ID、VA、CA和TLA值在有白膜层的睾丸组织中比没有白膜层的组织在统计学上显著更高（p<0.001）。结论 Ho:YAG激光对有无白膜层的睾丸组织有不同影响。在没有白膜层的睾丸组织中，激光对周围组织的影响最小，特别是在ID、VA和TLA方面。激光的这种最小影响在诸如保留睾丸手术（TSS）或睾丸精子提取（TESE）等睾丸手术过程中可能是一个优势。
