V1400 CIRCUMFERENTIAL HOLMIUM LASER ABLATION OF URETHRAL STRICTURE

Abstract

You have accessJournal of UrologyInfertility, Sexual Dysfunction, Trauma & Teaching Techniques1 Apr 2010V1400 CIRCUMFERENTIAL HOLMIUM LASER ABLATION OF URETHRAL STRICTURE Hemendra Shah Hemendra ShahHemendra Shah More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2010.02.1071AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES To evaluate feasibility, safety and short term efficacy of transurethral Holmium laser circumferential ablation of urethral stricture. The hemostatic nature of the holmium laser along with its haemostatic property makes it an ideal energy source for ablation of urethral stricture. It was our presumption that removal of the fibrous tissue may help to minimize the possibility of recurrent stricture and improve the results of endoscopic managment of urethral stricture. METHODS From April 2003 to September 2009, 72 patients underwent circumferential holmium laser ablation of urethral stricture at our institute. The mean age was 47.3 years (range: 22 – 91 years). The etiology of stricture included: Post TURP (19); Post-HOLEP (3); Post other instrumentation (16); Post-exposure urethritis (13) & Idiopathic (21). Of these 28 patients had recurrent stricture. Ascending urethrogram was done in all patients to diagnose presence of stricture. The procedure was performed using 550 μ laser fiber and 20 W energy. It consist of deep cutting at 12 o clock position followed by vaporization and resection of circumferential scar tissue. A 16 Fr. Foleys catheter was placed postoperatively for 1-3 days depending on depth of spongio-fibrosis. At 2 weeks all patients underwent urethral calibration & were taught CIC with 16 Fr. Tiemen's catheter. Recurrence was defined as either failure to do CIC due to urethral narrowing or recurrence on symptoms. RESULTS No major intra-operative or post operative complications. One patient had extravasation of normal saline in the peno-scrotal area. At mean follow-up of 29.4 months (0 – 73 months), 14 patients (19.44 %) developed recurrent stricture.Remaining 48 patients were stable with CIC. 10 patients were lost for follow-up. CONCLUSIONS Holmium laser circumferential ablation of urethral stricture appear to have promising early results. It is a safe, effective and minimally invasive therapeutic modality for male urethral stricture. However further randomized studies with long follow-up are necessary to determine the clinical value of this modality in treatment of urethral stricture. Mumbai, India© 2010 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 183Issue 4SApril 2010Page: e540-e541 Advertisement Copyright & Permissions© 2010 by American Urological Association Education and Research, Inc.MetricsAuthor Information Hemendra Shah More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...