An ex vivo experimental study comparing the effects of the holmium: yttrium-aluminum-garnet and thulium fiber lasers on testicular tissue.

The effects of lasers on testicular tissue have not yet been investigated in detail. In this experimental ex vivo study, we aimed to demonstrate and compare the effects of the holmium:yttrium-aluminum-garnet (Ho:YAG) and thulium fiber laser (TFL) lasers on testicular tissue. An ex vivo experiment was performed using calf testes. A 100W Ho:YAG laser and a 60W TFL devices with a setting spectrum at 10-60W, a frequency of 20-40 Hz, energy levels at 0.5-1-1.5 J, and medium pulse duration were tested. Histopathological parameters such as Incision depth (ID), vaporization area (VA), coagulation area (CA), and total laser area (TLA = VA + CA) were evaluated. In testicular tissue without a tunica layer, a statistically significant difference was found in the mean VA and TLA values between the Ho:YAG and TFL, in favor of Ho:YAG (p = 0.003, p = 0.003, respectively). In testicular tissue with a tunica layer, there was a statistically significant difference in mean VA, CA, TLA, ID values between Ho:YAG and TFL, in favor of Ho:YAG (all p < 0.001). At 1.5 J-20 Hz and 1.5 J-40 Hz, we observed that the features indicating tissue dissection, such as VA and ID, were lower in the TFL than those in Ho:YAG, while CA values were higher. VA, CA, TLA, ID values were significantly increased in tissue with tunica compared to non-tunicated tissue in both the Ho:YAG and TFL applications. At 30W and 60W, the penetrative effect of the TFL on tissue was less than that of the Ho:YAG, but its coagulation property was superior. What is Known: • Ho:YAG and TFL lasers are widely used in urology, primarily for stone and prostate surgeries, with established tissue effects in these contexts. What is New: • This study is the first to examine and compare the histopathological effects of these lasers on testicular tissue, providing insights into their potential applications in testicular surgery.