Holmium laser ablation of recurrent strictures of urethra and bladder neck: preliminary results.
BACKGROUND
The management of patients with recurrent urethral strictures represents a challenge for the practicing urologist.


METHODS
We used holmium:yttrium-aluminum-garnet (Ho:YAG) laser in the management of recurrent urethral strictures in 13 patients. The energy level was set at 1.0 at a frequency of 10 pulses/sec. No treatment complications were observed. The mean preoperative maximum flow rate by uroflowmetric analysis was 3.8 mL/sec.


RESULTS
Nine patients (69%) continue to do well with no symptoms at a median follow-up of 27 months with a mean maximum flow rate of 19 mL/sec. Of the four patients in whom treatment failed, three were retreated with the Ho:YAG laser. One of them was managed by insertion of a permanent urethral stent, another continues to do well without any further treatment, and the other is managed with dilation by self-catheterization. One of the four failures underwent open reconstructive urethroplasty after recurrence following his first treatment with the Ho:YAG laser.


CONCLUSIONS
Our preliminary results suggest that Ho:YAG laser ablation of urethral strictures is safe and might be a reasonable alternative endoscopic treatment for recurrent urethral strictures.
Kural
A R
AR
Department of Urology, International Hospital, Istanbul, Turkey. Kural@superonline.com
Coskuner
E R
ER
Cevik
I
I
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003558:Cystoscopy; D005260:Female; D006801:Humans; D017075:Laser Coagulation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012086:Reoperation; D017211:Treatment Failure; D014524:Urethral Obstruction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001748:Urinary Bladder Neck Obstruction / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D014563:Urodynamics; D014567:Urography