Thulium laser urethrotomy for urethral stricture: a preliminary report.

Abstract

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.

• Authors: Linhui Wang, Zhixiang Wang, Bo Yang, Qing Yang, Yinghao Sun
• Journal: Lasers in surgery and medicine (Lasers Surg Med) Vol. 42 Issue 7 Pg. 620-3 (Sep 2010) ISSN: 1096-9101 [Electronic] United States
• PMID: 20806387 (Publication Type: Evaluation Study, Journal Article)
• Copyright: 2010 Wiley-Liss, Inc.

Chemical References

• Thulium

Topics

• Adult
• Aged
• Aged, 80 and over
• Follow-Up Studies
• Humans
• Laser Therapy (methods)
• Male
• Middle Aged
• Minimally Invasive Surgical Procedures (instrumentation)
• Recurrence
• Reoperation
• Thulium (therapeutic use)
• Treatment Outcome
• Ureteroscopy
• Urethra (surgery)
• Urethral Stricture (surgery)