Experience of 138 Transurethral Urethrotomy With Holmium:YAG Laser

Abstract

Introduction: Many valid option modalities are available for the management of urethral stricture disease (USD), such as internal urethrotomy which has the success rates of 33%–60%. The aim of this study was to assess the outcome of holmium: YAG (Ho: YAG) laser urethrotomy (HLU). Methods: One hundred thirty-eight patients with urethral stricture with the mean age of 48±3.03 years old treated by HLU from March 2011 to August 2017. The main purpose of this investigation was to evaluate mean operation time, stricture recurrence rate and post-operation Qmax and complications of transurethral HLU. Results: The most common cause of USD was trauma in 82 (59.4%) patients. Mean laser operation time, mean hospital stay and mean postoperative duration of catheterization were 23.08 ± 9.1 minutes, 19.02 ± 10.7 hours and 10.3 ± 1.05 days respectively. The mean Qmax was 8.3 ± 2.07 mL/s before surgery and 16 ±3.1 mL/s afterward. At the end of 12 months follow-up, a total of 37 (26.8%) patients developed recurrence of the stricture. Patients with posterior, longer urethral strictures and previous history of interventions have more recurrence rate of the stricture. Conclusion: HLU is minimally invasive and seems to be an effective and safe management option for primary, short, urethral strictures. The hospital stay is remarkably short and complications are negligible.

Holmium: YAG Versus Cold Knife Internal Urethrotomy in the Management of Short Urethral Strictures: A Randomized Controlled Trial

“…Karkan et al reported a 73.2% success rate with Holmium urethrotomy in their clinical experience with 138 patients (20). Evaluation of previous studies is shown in Table 4.…”

Comparison of Stone Retrieval Basket, Stone Cone and Holmium Laser: Which One Is Better in Retropulsion and Stone-Free Status for Patients with Upper Ureteral Calculi?

“…Today, the laser has an excellent application in urologic diseases. [22][23][24] Endoscopic laser lithotripsy (LL) is frequently used to manage patients with urolithiasis. 8,25 A number of lasers have been used for LL, of which the Ho:YAG has become one of the most frequently used one.…”

Is Holmium Laser Enucleation of the Prostate a Good Surgical Alternative in Benign Prostatic Hyperplasia Management? A Review Article

“…9 The Holmium laser has a good penetration depth, which helps in staunching blood; it is also used for other urologic surgeries, including urolithiasis, 10,11 bladder tumor, 6 genital skin lesion, 12 and urethrotomy. 13,14 The Holmium laser enucleation of the prostate (HoLEP) was introduced about 20 years ago as a surgical treatment for the lower urinary tract symptom (LUTS) resulting from BPH. 15 Despite some drawbacks such as a special equipment requirement and a steep learning curve, it seems that HoLEP is an efficient surgical approach to BPH.…”