Core-through urethrotomy using the neodymium: YAG laser for obliterative urethral strictures after traumatic urethral disruption and/or distraction defects: long-term outcome.

Abstract

PURPOSE:

We assessed the feasibility, efficacy and long-term outcome of neodymium (Nd):YAG laser core-through urethrotomy for posttraumatic urethral stricture.

MATERIALS AND METHODS:

Between May 1997 and April 2000, 65 patients 5 to 62 years old underwent laser core-through urethrotomy for posttraumatic urethral stricture. Most patients had been involved in a motor vehicle accident but 8 and 3 sustained trauma after tractor injury and a railroad accident, respectively. All patients underwent suprapubic cystostomy formation and 18 had previously undergone anastomotic urethroplasty, railroad or attempted cold knife core-through urethrotomy. Mean stricture length was 2.2 cm. on bi-directional uroradiography and endoscopy. All strictures were in the bulbomembranous urethra except 3, which were prostatic-supraprostatic. The procedure was technically unsuccessful in 4 cases. Core-through urethrotomy was performed using Nd:YAG a 600 mu. contact bare fiber at 15 to 20 W. on an outpatient basis. Catheter removal and voiding cystourethrography were performed at 6 weeks. Uroflowmetry and urethroscopy were done 3 months after urethral catheter removal. Followup was 9 to 44 months.

RESULTS:

Nd:YAG laser core-through urethrotomy was performed on an outpatient basis successfully in all except 4 cases without any intraoperative or postoperative complications. Blood transfusion was not required. Although most patients were symptom-free, a few underwent initial optical internal urethrotomy and/or endoscopic dilation before the stricture became stable. The urethral lumen was obliterated again in 2 cases.

CONCLUSIONS:

Nd:YAG laser core-through urethrotomy is feasible and effective with good long-term results for posttraumatic urethral stricture.

• Authors: P N Dogra, G Nabi
• Journal: The Journal of urology (J Urol) Vol. 167 Issue 2 Pt 1 Pg. 543-6 (Feb 2002) ISSN: 0022-5347 [Print] United States
• PMID: 11792915 (Publication Type: Journal Article)

Topics

• Adolescent
• Adult
• Child
• Child, Preschool
• Feasibility Studies
• Humans
• Laser Therapy
• Middle Aged
• Radiography
• Treatment Outcome
• Urethra (injuries, surgery)
• Urethral Stricture (diagnostic imaging, etiology, surgery)