Two-staged Nd:YAG Laser Internal Urethrotomy for Complete Urethral Stricture

Jung, Do Lin; Shim, Bong Suk

Abstract

In complete urethral stricture, visual internal urethrotomy has not so high success rate because of the difficulty in determining the precise direction of incision and the inadequacy in scar tissue removal. Nd:YAG laser internal urethrotomy vaporizes the fibrotic scar tissue on strictured urethra and make for re-epithelization of urethra without scar tissue formation. We report experiences of 11 cases of two-staged Nd:YAG laser internal urethrotomy for complete urethral stricture. Age of patients was ranged from 25 to 61 (mean; 42) years old. All of 11 cases developed after urethral injury and was complete urethral stricture. The aim of first stage of operation is to make communication through region of urethral stricture. At second stage of operation, we reconfirmed the direction of neourethra, excised and vaporized the fibrotic scar tissue on strictured urethra using Nd:YAG laser at all directions to achieve normal appearance as possible. Follow-up duration was 6-18 (mean; 14) months. There was no recurrence at all. After 6 months, maximal flow rate was 21-29 (mean; 23.7) ml/sec, and we could not find any stricture portion on retrograde urethrogram. As a conclusion, two-staged Nd:YAG laser internal urethrotomy for complete urethral stricture is a new alternative method, which has many advantages such as technical simplicity, clear operative field due to less bleeding, unnecessity, of adjuvant urethral dilation, and no recurrence rate after the operation.