Efficacy and safety of Thulium Laser for Treatment of short segment bulbomembranous Urethral Stricture

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Background: Evaluation of outcome of thulium laser urethrotomy for patients with urethral strictureas a minimally invasive treatment for urethral stricture. Objective: The purpose of this study was to evaluate Efficacy and safety of Thulium Laser for treatment of short segment bulbomembranous Urethral Stricture. Patient and methods: A prospective non controlled study conducted on twenty patients with urethral stricture selected from outpatient clinic of Al-Azhar-university hospital New Damietta in duration between June 2017 and July 2018. Evaluated by retrograde urethrography, uroflowmetry, International Prostate SymptomScore (IPSS), Sexual function assessment: International Index of Erectile Function (IIEF), Male Sexual Health Questionnaire (M.S.H.Q)] and quality of life preoperatively. All patients were treated with thulium laser urethrotomy. All patients were followed up for 6 months postoperatively by uroflowmetry and by retrograde urethrography after 6 months. And all patients were followed up by mailed questionnaire, including IPSS (International prostate symptom score), (IIEF), (M.S.H.Q) and quality of life. Result: Thulium laser urethrotomy was performed in all 20 cases. The mean operative time was 23.7±4.5 minutes range (15–30 minutes). No intraoperative complications were encountered. Despite perioperative antibiotics, 15% of the patients developed urinary tract infection postoperatively that was managed with antibiotics accordingto urine culture sensitivity. Stricture treatment was successful in 17 patients (85%). three patient developed recurrent stricture treated with urethral dilation. In 17 patient the postoperative mean Qave (average urine flow) > 12.3±3.6 ml /second (P <0.05) and adequate caliber urethra in retrograde urethrogram (RUG) 6 months after operation.Three patients (15%) showed narrow stream of urine) Qave) average urine flow Conclusion: We demonstrated that thulium laser endourethrotomy was a reliable and safe therapy with minimal invasive therapeutic modality for urethral strictures.