Int Neurourol J.  2013 Mar;17(1):24-29.

Treatment of Urethral/Bladder Neck Stricture After High-Intensity Focused Ultrasound for Prostate Cancer With Holmium: Yttrium-Aluminium-Garnet Laser

• Cho WJ
• Kim TH
• Lee HS
• Chung JW
• Lee HN
• Lee KS

Abstract

PURPOSE
To evaluate the efficacy and safety of the Holmium: yttrium-aluminium-garnet (YAG) laser for the treatment of urethral/bladder neck strictures after high-intensity focused ultrasound for prostate cancer.
METHODS
Between February 2007 and July 2010, Holmium: YAG laser urethrotomies were performed in eleven patients for bladder neck strictures or prostatic urethral strictures. The laser was used with a 550-microm fiber at 2 J and frequency 30 to 50 Hz. The medical records were retrospectively reviewed for medical history, perioperative and postoperative data, uroflowmetry, International Prostate Symptoms Score/quality of life, and stricture recurrence.
RESULTS
At a median follow-up of 12.0 months (range, 4 to 35 months), the mean postoperative maximal flow rate and residual volume were improved significantly (P<0.05). The mean postoperative total, voiding and quality of life of international prostate symptom score were improved significantly (P<0.05). Of the 11 patients, 7 patients required one treatment, 4 patients two treatment, and 1 patients three treatment. 2 patients who had a documented urinary incontinence prior to the laser treatment subsequently required artificial urinary sphincter implantation and reported satisfaction without developing any recurrent strictures or artificial urinary sphincter erosion. All patients exhibited well-healed strictures and could void without difficulty.
CONCLUSIONS
Holmium: YAG laser therapy represents a safe, effective and minimally invasive treatment for urethral/bladder neck strictures occurring secondary to high-intensity focused ultrasound for prostate cancer.

Keyword

Transrectal high-intensity focused ultrasound; Holmium; Prostate neoplasms; Urethral stricture; Urinary bladder neck obstruction

MeSH Terms

Constriction, Pathologic
Follow-Up Studies
Holmium
Humans
Lasers, Solid-State
Medical Records
Neck
Prostate
Prostatic Neoplasms
Quality of Life
Residual Volume
Retrospective Studies
Ultrasound, High-Intensity Focused, Transrectal
Urethral Stricture
Urinary Bladder
Urinary Bladder Neck Obstruction
Urinary Incontinence
Urinary Sphincter, Artificial
Holmium