title: Use of holmium:YAG laser in posterior urethral valves: another method of fulguration.
abstract: OBJECTIVE
  To evaluate the use of holmium:YAG laser for posterior urethral valve (PUV) fulguration and compare with electro-fulguration.
  
  
  METHODS
  Forty boys underwent primary fulguration of PUV using 20-25 W holmium laser (Group 1) from January 2009 to December 2011. Data of last 40 boys (retrospective cohort: January 2005 to December 2008) who underwent electro-fulguration (Group 2) for PUV were compared with group 1. Ultrasonography was done at 2 weeks and 3 months and voiding cystourethrography at 3 and 6 months respectively after fulguration and as needed thereafter. DTPA scan and urodynamic study were performed during follow-up in select patients, as required.
  
  
  RESULTS
  Pre-operative parameters were comparable between groups. Improvement in voiding occurred in 38 and 34 boys in group 1 and 2, respectively. Hydroureteronephrosis and vesico-ureteric reflux resolved in 53% and 60% in group 1 and 51% and 53% in group 2, respectively. Boys in group 1 had statistically significant greater success in voiding after catheter removal (40 vs 32), shorter period of catheterization (1 vs 1.8 days), lower mean operative time (15 vs 20 min), needed re-fulguration less commonly (2 vs 6), and were less likely to develop urethral stricture (0 vs 2) and urinary incontinence (0 vs 1).
  
  
  CONCLUSIONS
  PUV fulguration using holmium:YAG laser is a feasible, safe and effective alternative for endoscopic transurethral ablation with similar success, and appears to have fewer complications than electro-fulguration.
authors: Department of Urology, King George's Medical University, (Formerly, Chhatrapati Shahuji Maharaj Medical University), Lucknow, India.
authors: Swarnendu
authors: S
authors: Mandal
authors: Apul
authors: A
authors: Goel
authors: Manoj
authors: M
authors: Kumar
authors: Manish Kumar
authors: MK
authors: Singh
authors: Vishwajeet
authors: V
authors: Singh
authors: Satya N
authors: SN
authors: Sankhwar
authors: Bhupender P
authors: BP
authors: Singh
authors: Divakar
authors: D
authors: Dalela
mesh_terms: D002648:Child; D002675:Child, Preschool; D004564:Electrocoagulation / Q000295:instrumentation* / Q000379:methods*; D005260:Female; D006801:Humans; D006869:Hydronephrosis / Q000000981:diagnostic imaging / Q000601:surgery; D007223:Infant; D053844:Lasers, Solid-State / Q000627:therapeutic use*; D008297:Male; D011183:Postoperative Complications / Q000517:prevention & control; D011859:Radiography; D012189:Retrospective Studies; D014463:Ultrasonography; D014521:Urethra / Q000000981:diagnostic imaging / Q000601:surgery*; D014525:Urethral Stricture / Q000000981:diagnostic imaging / Q000601:surgery*; D014563:Urodynamics; D014718:Vesico-Ureteral Reflux / Q000000981:diagnostic imaging / Q000601:surgery
keywords: Posterior urethral valve; Valve fulguration