Urethrotomy by holmiun laser combined pediatric ureteroscopy in the treatment of male urethral stricture

Abstract

Objective To explore the safety and clinical efficacy of urethrotomy by holmiun laser combined pediatric ureteroscopy in the treatment of male urethral stricture. Methods From August 2014 to April 2017, 42 male patients with urethral stricture treated by holmiun laser combined pediatric ureteroscopy in our hospital were retrospectively analyzed. Patients' age ranged from 23 to 72 years (mean 43 years). There were 18 cases of membranous part of urethral stricture, 5 cases of prostatic urethral stricture and 19 cases of anterior urethral stricture. The length of urethral stricture rangedfrom 0.3-2.5 cm (mean 1.4±0.3 cm), and the length ranged from 2.0-2.5 cm in two of them. Thirty eight cases were carried out with uroflowmetry, preoperative maximum flow rate(Qmax) was 2.5-7.8 ml/s (mean 4.5±1.2 ml/s).The urethral catheter was removed 4-6 weeks after surgery. All patients were carried out with urethra dilatation once per week (total 3-4 times), and regular reexamination of urinary flow rate. Results All patients underwent surgery successfully, and the operative time was 30-70 min, with an average of (48±9) min, the blood loss was little. All patients voided smoothly after removal of catheter. No complications such as bleeding, urinary extravasation, perforation and infection occurred. After 6-12 months of follow-up, 39 patients were voiding smoothly, and maximum flow rate(Qmax) was 12.6-22.5 ml/s (mean 16.3±3.7 ml/s), After 3 months, 3 patiens were found that urinary flow rate was decreasing, which was cured by dilating the urethra 3-4 times. Conclusion Urethrotomy by holmiun laser combined pediatric ureteroscopy is safe and effective for the treatment of male urethral stricture .The recent curative effect is good. Key words: Pediatric ureteroscopy; Holmium laser; Urethral stricture