Holmium:YAG laser for treatment of strictures of vesicourethral anastomosis after radical prostatectomy.

Abstract

BACKGROUND AND PURPOSE:

Strictures of the vesicourethral anastomosis (VUA) following radical prostatectomy tend to recur. We used the holmium:YAG laser for treatment of recurrent stricture of the VUA. We evaluated the technique and its efficacy.

PATIENTS AND METHODS:

In 10 patients, the Ho:YAG laser was used with a 365-mum fiber at a setting of 2 J and frequency 10 to 20 Hz, creating a deep incision of the scar tissue at the 6 o'clock position. This was followed by a vaporizing resection of the remaining scar tissue between 3 and 9 o'clock. We aimed to vaporize up to well-vascularized surrounding tissue. Retrospectively, the charts were reviewed for hospital stay, voiding complaints, recurrence of stenosis, complications, and flow rates. The mean follow-up was 18 months.

RESULTS:

There were no operative complications. After removal of the catheter, all patients could void without difficulty. No re-treatment was needed for recurrent stenosis. Any existing irritative voiding complaints or incontinence did not change after treatment. In all patients, the flow pattern improved: the mean maximum flow rate increased, and the mean postvoiding residual volume decreased.

CONCLUSION:

The Ho:YAG laser seems to be a safe and effective treatment for first or recurrent strictures of the VUA after radical prostatectomy.

• Authors: Brunolf W Lagerveld, M Pilar Laguna, Frans M J Debruyne, Jean J M C H De La Rosette
• Journal: Journal of endourology (J Endourol) Vol. 19 Issue 4 Pg. 497-501 (May 2005) ISSN: 0892-7790 [Print] United States
• PMID: 15910265 (Publication Type: Journal Article)

Topics

• Aged
• Anastomosis, Surgical (adverse effects)
• Follow-Up Studies
• Humans
• Laser Therapy
• Male
• Middle Aged
• Prostatectomy (adverse effects)
• Prostatic Neoplasms (surgery)
• Recurrence
• Retrospective Studies
• Treatment Outcome
• Urethra (surgery)
• Urethral Stricture (etiology, surgery)
• Urinary Incontinence (etiology, surgery)
• Urodynamics