Korean J Urol.  2009 Mar;50(3):246-250.

Initial Experience with Endoscopic Holmium: YAG Laser Urethrotomy for Incomplete Urethral Stricture

• Choi SH
• Lee YS
• Choi NG
• Kim HJ

Abstract

PURPOSE: Endoscopic holmium:yttrium-aluminum-garnet (Ho:YAG) laser urethrotomy is an alternative method in the management of urethral strictures. We report our initial experience in 15 cases of evaluating the therapeutic efficacy of the holmium laser for treating incomplete urethral strictures.
MATERIALS AND METHODS
Endoscopic holmium laser urethrotomy was primarily performed on 15 patients with incomplete urethral stricture. Exclusion criteria were complete urethral stricture and previous treatment of urethral stricture. Retrograde urethrography and uroflowmetry were performed preoperatively and were carried out as follow-up studies postoperatively.
RESULTS
Successful results without recurrence were achieved in 8 of 15 patients. When we classified the results by stricture length, the success rate was 80% in strictures less than 2 cm, whereas there was no therapeutic effect in strictures over 2 cm. When we classified the results by etiology, the number of successful results in strictures with an inflammatory, trauma, iatrogenic, or unknown cause was 2 (2/8), 3 (3/4), 2 (2/2), and 1 (1/1), respectively. In 7 patients who failed treatment, we repeated holmium laser urethrotomy in 5 patients and urethroplasty in 2 patients. No operative complications occurred in any patients.
CONCLUSIONS
Endoscopic holmium laser urethrotomy is a safe and effective minimally invasive therapeutic modality in cases of stricture less than 2 cm. Further data from long-term follow-up are necessary to compare the success rate with that of conventional urethrotomy and urethroplasty.

Keyword

Holmium; Urethral stricture; Internal urethrotomy

MeSH Terms

Constriction, Pathologic
Follow-Up Studies
Holmium
Humans
Lasers, Solid-State
Recurrence
Urethral Stricture
Holmium

Figure

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  Fig. 1. Retrograde urethrogram showing incomplete urethral stricture (arrow).

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  Fig. 2. Postoperative retrograde urethrogram showing good patency.

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