Systems, devices, and methods for temperature and pressure management of an anatomic site are provided. A system can include a scope configured to provide a view of an anatomic site, an energy delivery device configured to deliver therapy energy to the anatomic site, a first irrigation conduit configured to transfer fluid to the anatomic site, a first temperature sensor situated to provide first temperature data associated with the anatomic site, and control circuitry electrically coupled to receive the first temperature data, the control circuitry being configured to adjust, based at least in part on the first temperature data, at least one of (i) a first temperature of the fluid, (ii) a flow parameter of the fluid, or (iii) a setting of the energy delivery device to manage a second temperature of the anatomic site.