Neodymium:YAG laser incision of congenital obstructive posterior urethral membrane in boys with urinary incontinence and low uroflow.
OBJECTIVE
Congenital obstructive posterior urethral membrane (COPUM) is associated with sub-clinical lower urinary tract symptoms in boys. Urethral stricture following cystoscopic fulguration of the membrane and a relatively small urethral caliber make the treatment of this condition difficult.


METHODS
Fifteen boys (mean age, 10.0 years) with COPUM were treated with neodymium:YAG (Nd:YAG) contact laser incision of the membrane through a cystourethroscope (n = 7) or a ureteroscope (n = 8).


RESULTS
Presenting symptoms were bedtime incontinence in 15, frequency/urgency in 10, daytime incontinence in 7, lazy bladder in 3 and urinary tract infection in 2. All patients had an obstructive urinary flow pattern with a maximal flow rate (Q(max)) < 15 mL/s. The mean follow-up period was 10.5 months. After the surgery, the number of wet nights per week reduced > 90%, 50-90% and < 50% in 9 (60%), 5 (33.3%), and 1 (6.7%), respectively. Mean (Q(max)) increased from 11.3 to 14.9 mL/s (p = 0.003).


CONCLUSIONS
Nd:YAG laser incision of COPUM with the aid of a ureteroscope or a cystourethroscope is a safe and effective method for improving urinary flow and bedtime incontinence.
Tsai
Yao-Chou
YC
Department of Urology, En Chu Kong Hospital, Taipei Hsien 237, Taiwan.
Yang
Stephen Shei-Dei
SS
Wang
Chung-Cheng
CC
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D020684:Cystoscopes; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D008297:Male; D009354:Neodymium; D020709:Ureteroscopes; D014521:Urethra / Q000002:abnormalities*; D014524:Urethral Obstruction / Q000151:congenital* / Q000601:surgery*; D014549:Urinary Incontinence / Q000209:etiology / Q000601:surgery*; D014563:Urodynamics; D015019:Yttrium
D009354:Neodymium; D015019:Yttrium