Adjuvant therapy with Nd-YAG laser and triamcinolone injection in the treatment of urethral stricture

Jeon, June Young; Shim, Bong Suck

Abstract

Treatment of benign urethral strictures is difficult because of a high rate of recurrence. In general, electrocautery resection of fibrous scar tissues has been unsatisfactory. Since the irregular thermal injury may only promote further scarring. Because of their unique physical properties and tissue erect lasers theoretically offer advantages over conventional techniques for treatment of urethral strictures. The thermal injury resulting from neodymium:YAG laser irradiation may heal with more elastic properties and less fibrous contraction than an electocautery bum. According endoscopic application of laser energy could produce thermal coagulation of the fibrous area with a secondary slough or the scar tissue and reepithelization without scar. Contraction and epithelization are two phenomena of wound healing which are retarded by steroid Triamcinolone activates collagenase which enhanced degradation of scar tissue. A totaI 28 cases with benign urethral strictures underwent treatment with circumferential triamcinolone injection and application of neodymium:YAG laser irradiation to the scarred area after endoscopic cold urethrotomy. There were no adverse effects and although 6 patients suffered recurrent strictures within 2-17 months. the postoperative results were good in all patients including recurrent cases. We reviewed our experience with neodymium:YAG laser treatment of benign urethral strictures.