Abstract
Background:
The management of patients with recurrent urethral strictures represents a challenge for the practicing urologist.
Patients and Methods:
We used holmium:yttrium–aluminum-garnet (Ho:YAG) laser in the management of recurrent urethral strictures in 13 patients. The energy level was set at 1.0 at a frequency of 10 pulses/sec. No treatment complications were observed. The mean preoperative maximum flow rate by uroflowmetric analysis was 3.8 mL/sec.
Results:
Nine patients (69%) continue to do well with no symptoms at a median follow-up of 27 months with a mean maximum flow rate of 19 mL/sec. Of the four patients in whom treatment failed, three were retreated with the Ho:YAG laser. One of them was managed by insertion of a permanent urethral stent, another continues to do well without any further treatment, and the other is managed with dilation by selfcatheterization. One of the four failures underwent open reconstructive urethroplasty after recurrence following his first treatment with the Ho:YAG laser.
Conclusion:
Our preliminary results suggest that Ho:YAG laser ablation of urethral strictures is safe and might be a reasonable alternative endoscopic treatment for recurrent urethral strictures.
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