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International Urology and Nephrology
Published in: International Urology and Nephrology 3/2012

Open Access 01-06-2012 | Urology - Original Paper

Comparison of treatment results between holmium laser endourethrotomy and optical internal urethrotomy for urethral stricture

Authors: Slawomir A. Dutkiewicz, Mariusz Wroblewski

Published in: International Urology and Nephrology | Issue 3/2012

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Abstract

Purpose

We comparatively evaluated urethral stricture (US) treatment outcomes, efficacy and complications, using either holmium laser endourethrotomy (HLU) or optical internal urethrotomy (OIU) since studies such as this are scarce in literature.

Methods

During 2003–2008, 50 men aged 17–78 years were operated on for primary or refractory US, 32 (64%) and 18 (36%) patients, respectively. The average stricture length was 1.86 cm. Strictures were single or multiple, forty-one (82%) and nine (18%) patients, respectively, and were located in the anterior or posterior urethra in 27 (54%) and 32 (64%) patients, respectively. US were iatrogenic in 32 (64%) and idiopathic in 18 (36%). Patients were divided into two groups, grpA and grpB, each containing 25 patients who were treated using either HLU or OIU, respectively. An evaluation scale of 1–3 was adopted and took maximum flow rate (Qmax), postvoid residual (PVR), and quality of life (QL) into consideration. A score of ‘1 was very good, ‘2 was good, and ‘3 was poor.

Results

Treatment results were evaluated after 3, 6, and 12 months, respectively. Evaluation of grpA was as follows: five (20%), nine (36%), and seven (28%) patients scored a ‘1; thirteen (52%), nine (20%), and four (16%) patients scored a ‘2; and seven (28%), eleven (44%), and fourteen (56%) patients scored a ‘3. Evaluation of grpB: seven (28%), ten (40%), and five (20%) patients scored a ‘1; eleven (44%), seven (28%), and ten (40%) patients scored a ‘2; and seven (28%), eight (32%), and ten (40%) patients scored a ‘3.

Conclusions

Neither complication rate nor degree of efficacy between HLU and OIU for US revealed a significant difference. We found both laser and conventional urethrotomies to be safe and effective modes of treatment.
Literature
1.
Sachse H (1974) Zur behandlung der Harnrohrenstriktur; Die transurethrale Schlitzung unter Sicht mit scharfen Schnitt. Fortschr Med 92:12–15
2.
Giannakopoulos X, Grammeniatis E, Gratzios A et al (1997) Sachse urethrotomy versus endoscopic urethrotomy plus transurethral resection of the fibrous callus (Guillemin’s technique) in the treatment of urethral stricture. Urology 49:243–247PubMedCrossRef
3.
Floratos DL, De la Rosette JJMCH (1999) Laser in urology. BJU Int 1(4):15–24
4.
Van Hillegersberg R (1997) Fundaments of laser surgery. Eur J Surg 163:3–11PubMed
5.
Wollin TA, Denstedt JD (1998) The holmium laser in urology. J Clin Laser Med Surg 16:13–20PubMed
6.
Kamp s, Knoll T, Osman MM et al (2006) Low-power Holmium: YAG laser urethrotomy for treatment of urethral strictures: functional outcome and quality of life. J Endourol 20(1):38–41PubMedCrossRef
7.
Costello AJ, Johnson DE, Bolton DM (1992) Nd: YAG laser ablation of the prostate as a treatment for benign prostatic hypertrophy. Lasers Surg Med 12:121–124PubMedCrossRef
8.
Dogra PN, Aron M, Rajeev TP (1999) Core through urethrotomy with the neodymium: YAG laser for posttraumatic obliterative strictures of the bulbomembranous urethra. J Urol 161(1):81–84PubMedCrossRef
9.
Dogra PN, Nabi G (2002) Core-through urethrotomy using the neodymium: YAG laser for obliterative urethral strictures after traumatic urethral disruption and/or distraction defects: long-term outcome. J Urol 167(2 Pt 1):543–546PubMed
10.
Dogra PN, Nabi G (2003) Nd-YAG laser core-through urethrotomy in obliterative posttraumatic urethral strictures in children. Pediatr Surg Int 19(9–10):652–655PubMedCrossRef
11.
Dogra PN, Nabi G (2002) Neodymium-YAG laser core through urethrotomy in obliterative posttraumatic urethral strictures after failed initial urethroplasty. Urol Int 68(4):265–267PubMedCrossRef
12.
Gurdal M, Tekin A, Yucebas E, Kirecci S, Sengor F (2003) Contact neodymium: YAG laser ablation of refractory urethral strictures using a side-firing fiber. J Endourol 17(9):791–794PubMedCrossRef
13.
Nabi G, Dogra PN (2002) Endoscopic management of post-traumatic prostatic and supraprostatic strictures using Neodymium-YAG laser. Int J Urol 9(12):710–714PubMedCrossRef
14.
Perkash I (1997) Ablation of urethral strictures using contact chisel crystal firing neodymium: YAG laser. J Urol 157(3):809–813PubMedCrossRef
15.
Adkins WC (1988) Argon laser treatment of urethral stricture and vesical neck contracture. Lasers Surg Med 8(6):600–603PubMedCrossRef
16.
Becker HC, Miller J, Noske HD, Klask JP, Weidner W (1995) Transurethral laser urethrotomy with argon laser: experience with 900 urethrotomies in 450 patients from 1978 to 1993. Urol Int 55(3):150–153PubMedCrossRef
17.
Guazzieri S, Bertoldin R, D’Inca G, De Marchi G, Mazzariol C, Galetti-Prayer T, Cecchetti W (2001) 980-nm diode laser treatment for refractory urethral strictures. Eur Urol 39(Suppl 2):19–22PubMedCrossRef
18.
Monga M, Gordon Z, Alexandrescu B (2001) Obliterated urethra: holmium: yttrium-aluminum-garnet cut-to-light with urolume stenting. Tech Urol 7(4):266–270PubMed
19.
Turek PJ, Malloy TR, Cendron M, Carpiniello VL, Wein AJ (1992) KTP-532 laser ablation of urethral strictures. Urology 40(4):330–334PubMedCrossRef
20.
Montorosi F, Naspo R, Salonia A et al (2004) Holmium laser enucleation versus transurethral resection of the prostate: results from a 2-center, prospective, randomized trial in patients with obstructive benign prostatic hyperplasia. J Urol 172:1926–1929CrossRef
21.
Matsouka K, Inoue M, Iida S et al (2002) Endoscopic antegrade laser incision in the treatment of urethral stricture. Urology 60:968–972CrossRef
22.
Hossain AZ MZ, Khan SA, Hossain S, Salam MA (2004) Holmium laser urethrotomy for urethral stricture. Bangladesh Med Res Counc Bull 30(2):78–80PubMed
23.
Dogra PN, Ansari MS, Gupta NP, Tandon S (2004) Holmium laser core- through urethrotomy for traumatic obliterative strictures of urethra: initial experience. Urology 64(2):232–235 discussion 235–6PubMedCrossRef
24.
Gupta NP, Ansari MS (2004) Holmium laser core through internal urethrotomy with explanation of urolume stent. An ideal approach for a complicated posterior urethral stricture. Int J Urol 11(5):343–344PubMedCrossRef
25.
Hayashi T, Yoshinaga A, Ohno R, Ishii N, Watanabe T, Yamada T, Kihara K (2005) Successful treatment of refractory vesicourethral stricture after radical prostatectomy with holmium laser: report of three cases. Int J Urol 12(4):414–416PubMedCrossRef
26.
Futao S, Wentong Z, Yan Z, Qingyu D, Aiwu L (2006) Application of endoscopic Ho:YAG laser incision technique treating urethral strictures and urethral atresias in pediatric patients. Pediatr Surg Int 22(6):514–518PubMedCrossRef
27.
Peterson AC, Webster GD (2004) Management of urethral stricture disease: developing options for surgical intervention. BJU Int 94(7):971–976PubMedCrossRef
28.
Borówka A w Borkowski A, Borówka A (1990) Urazy narządów miednicy mniejszej i zewnętrznych narządów płciowych. PZWL, Warszawa, pp 154–6
Metadata
Title
Comparison of treatment results between holmium laser endourethrotomy and optical internal urethrotomy for urethral stricture
Authors
Slawomir A. Dutkiewicz
Mariusz Wroblewski
Publication date
01-06-2012
Publisher
Springer Netherlands
Published in
International Urology and Nephrology / Issue 3/2012
Print ISSN: 0301-1623
Electronic ISSN: 1573-2584
DOI
https://doi.org/10.1007/s11255-011-0094-8

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