[Treatment of ureteral obstruction by holmium: YAG laser endoureterotomy: a report of 18 cases].
OBJECTIVE
To investigate the clinical value and safety of holmium: YAG laser endoureterotomy in the treatment of ureteral obstruction.


METHODS
Holmium: YAG laser endoureterotomy, with the laser optic fiber 550 microm in diameter and the output power of 3.5 Watt, via ureteroscopy, was performed on 18 patients ureteral obstruction, 8 males and 10 females, aged 52.1 (34-67), 11 with the stricture in the upper segment (complete obstruction in 4 cases), 5 in the middle segment, and 2 in lower segment; and 6 cases complicated with ureteral calculus. Postoperatively, an orthopedic ureteral stent (a 6-Fr double-J ureteral stent with a movable 5 cm length 9-Fr orthopedic cannula) was remained indwelling for 3-6 months. Follow-up was conducted for 10.7 (2-14) months.


RESULTS
The operative duration was 32 (25-70) minutes. One patient underwent failed endoureterotomy and was turned to percutaneous nephroscopy. Success was achieved in 16 patients. The glomerular filtration rate (GFR) of these affected kidneys increased from 16.4+/-6.9 ml/min ante-operatively to 24.9+/-8.2 ml/min (P<0.01) postoperatively. One kidney was resected because of non-function, with GFR of 2 ml/min and intractable pyelitis. No recurrence of ureteral stricture was observed.


CONCLUSIONS
Holmium: YAG laser endoureterotomy with insertion of orthopedic ureteral stent is an efficient and safe treatment for ureteral strictures with minimal invasion, less complications and easy recovery. This operation should be performed with a thorough preparation and severely restricted indication.
Fu
Yi-ming
YM
Second Department of Urology, First Affiliated Hospital of Harbin Medical University, Harbin 150001, China.
Ni
Shao-bin
SB
Chen
Qi-yin
QY
Zhao
Zhong-shan
ZS
Ren
Ming-hua
MH
Ma
Li
L
Jiao
Zhi-xing
ZX
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053685:Laser Therapy; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014517:Ureteral Obstruction / Q000601:surgery*; D018666:Ureteroscopy / Q000379:methods*