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Thulium laser urethrotomy for urethral stricture: A preliminary report
Author(s) -
Wang Linhui,
Wang Zhixiang,
Yang Bo,
Yang Qing,
Sun Yinghao
Publication year - 2010
Publication title -
lasers in surgery and medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.888
H-Index - 112
eISSN - 1096-9101
pISSN - 0196-8092
DOI - 10.1002/lsm.20934
Subject(s) - medicine , urethrotomy , urethral stricture , surgery , urethroplasty , urethra , voiding cystourethrogram , urinary system , urology , reflux , disease , vesicoureteral reflux
Background and Objectives The outcome of thulium laser urethrotomy for patients with urethral stricture had not been reported. The purpose of this study was to evaluate outcome of endourethrotomy with the thulium laser as a minimally invasive treatment for urethral stricture. Materials and Methods Twenty‐one consecutive patients with urethral stricture were evaluated by retrograde uroflowmetry, International Prostate Symptom Score (IPSS), and quality of life preoperatively at a single academic center. All patients were treated with thulium laser urethrotomy. All patients were followed up for 12–24 months postoperatively by uroflowmetry and by retrograde with voiding cystourethrogram every 3 months. And all patients were followed up by mailed questionnaire, including IPSS and quality of life. Results Retrograde endoscopic thulium laser urethrotomy was performed in all 21 patients. Most patients (N = 16; 76.2%) did not need any reintervention. Five patients developed recurrent strictures, of them two patients were treated by another laser urethrotomy, one patient was treated by open urethroplasty with buccal mucosa and the other two patients' reintervention were treated by urethral dilation. No intraoperative complications were encountered, although in 9.5% (N = 2) of patients, a urinary tract infection was diagnosed postoperatively. No gross hematuria occurred. Including two patients treated with repeat laser urethrotomy, 17(81.0%) showed good flow of urine ( Q ave >16.0 ml/second) and adequate caliber urethra in retrograde urethrogram (RGU) 12 months after operation. Three (14.3%) patients showed narrow stream of urine ( Q ave <8.0 ml/second) and urethral dilation was done every month or 2 months. There was one patient whose Q ave was between 8.0 and 16.0 ml/second. And this patient was treated by neither urethral dilation nor another laser urethrotomy. Conclusions The thulium laser urethrotomy was a safe and effective minimally invasive therapeutic modality for urethral stricture. Lasers Surg. Med. 42:620–623, 2010. © 2010 Wiley‐Liss, Inc.