Transurethral 2-microm laser in the treatment of urethral stricture

To evaluate the curative efficacy of transurethral 2-mum thulium laser urethrotomy in the treatment of urethral stricture.

Two hundred and thirty-eight patients suffering from urethral stricture, all male, aged 47.3 (36-58), underwent transurethral 2-mum thulium laser urethrotomy. The maximum flow rate (MFR), the international prostatic symptom score (IPSS) and the quality of life (QoL) were measured before operation, immediately following the removal of the catheter, and 3 and 6 months postoperatively.

The surgery was performed for all the patients with no rectum injury, urine leakage or massive blood loss. All the patients got free urination immediately following the catheter removal with the mean MFR improved from (3.2 + or - 0.3) ml/s preoperatively to (16.7 + or - 3.1) ml/s, which kept steady to (18.7 + or - 2.9) and (19.2 + or - 2.8) ml/s, respectively 3 and 6 months after operation. IPSS significantly improved from 28.3 + or - 5.8 preoperatively to 7.1 + or - 1.9, 6.4 + or - 1.5 and 5.3 + or - 1.3, respectively when catheter removal and 3 and 6 months after operation. Also during the corresponding period, mean QoL improved from 5.4 + or - 1.1 to 1.1 + or - 0.3, 0.9 + or - 0.2 and 0.8 + or - 0.2. 195, patients got permanent uninterrupted urination without recurrence in the whole 6 months of follow-up. Forty-three patients got recurrence and seven patients encountered with incontinence 1-3 weeks (mean 13.8 days) after catheter removal, but they all got final cure after periodic urethral dilatation and physical exercise.

Transurethral 2-mum thulium laser is safe and efficient in the treatment of urethral stricture.