Occupational Hearing Loss Risk in Endourologic Procedures: PCNL, URS, HOLEP, SWL, and Ultrasound Insights

The study investigates the intraoperative noise levels during common endourologic procedures, highlighting the risk of occupational hearing loss for endourologists. Endourologists face various environmental noises in operating rooms, including those from suction devices and personnel, along with exposure to electromagnetic, ballistic, ultrasonic, and laser energies. Prolonged exposure to high noise levels can impair communication and lead to irreversible noise-induced hearing loss. To evaluate this, sound pressure levels were measured using the National Institute for Occupational Safety and Health sound level meter app on iPhones positioned within 2 meters of the surgeon’s head during 15 consecutive surgical cases. The procedures monitored included ureteroscopy (URS) with holmium and thulium lasers, holmium enucleation of the prostate (HoLEP), percutaneous nephrolithotomy (PCNL), and extracorporeal shock wave lithotripsy (SWL). Results indicated that PCNL produced the highest mean time-weighted average (TWA) noise exposure at 70.2±6.3 dB, significantly louder than other procedures. HoLEP also showed elevated levels at 61.2±8.5 dB, while SWL and thulium URS registered lower averages. Notably, while noise levels did not exceed the National Institute for Occupational Safety and Health’s (NIOSH) safety threshold of 85 dB for a 40-hour workweek, they surpassed levels that could interfere with speech, potentially affecting the mental well-being of surgical staff. This research underscores the need for further studies to assess the long-term effects of noise exposure, especially during lengthy PCNL procedures, and to consider the benefits of hearing protection for medical personnel.