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Randomized Controlled Trial
. 2012 Jun;44(3):717-24.
doi: 10.1007/s11255-011-0094-8. Epub 2011 Nov 30.

Comparison of treatment results between holmium laser endourethrotomy and optical internal urethrotomy for urethral stricture

Slawomir A Dutkiewicz  1 , Mariusz Wroblewski
Affiliations
Randomized Controlled Trial

Comparison of treatment results between holmium laser endourethrotomy and optical internal urethrotomy for urethral stricture

Slawomir A Dutkiewicz et al. Int Urol Nephrol. 2012 Jun.

Abstract

Purpose: We comparatively evaluated urethral stricture (US) treatment outcomes, efficacy and complications, using either holmium laser endourethrotomy (HLU) or optical internal urethrotomy (OIU) since studies such as this are scarce in literature.

Methods: During 2003-2008, 50 men aged 17-78 years were operated on for primary or refractory US, 32 (64%) and 18 (36%) patients, respectively. The average stricture length was 1.86 cm. Strictures were single or multiple, forty-one (82%) and nine (18%) patients, respectively, and were located in the anterior or posterior urethra in 27 (54%) and 32 (64%) patients, respectively. US were iatrogenic in 32 (64%) and idiopathic in 18 (36%). Patients were divided into two groups, grpA and grpB, each containing 25 patients who were treated using either HLU or OIU, respectively. An evaluation scale of 1-3 was adopted and took maximum flow rate (Q(max)), postvoid residual (PVR), and quality of life (QL) into consideration. A score of '1 was very good, '2 was good, and '3 was poor.

Results: Treatment results were evaluated after 3, 6, and 12 months, respectively. Evaluation of grpA was as follows: five (20%), nine (36%), and seven (28%) patients scored a '1; thirteen (52%), nine (20%), and four (16%) patients scored a '2; and seven (28%), eleven (44%), and fourteen (56%) patients scored a '3. Evaluation of grpB: seven (28%), ten (40%), and five (20%) patients scored a '1; eleven (44%), seven (28%), and ten (40%) patients scored a '2; and seven (28%), eight (32%), and ten (40%) patients scored a '3.

Conclusions: Neither complication rate nor degree of efficacy between HLU and OIU for US revealed a significant difference. We found both laser and conventional urethrotomies to be safe and effective modes of treatment.

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Figures

Fig. 1
Fig. 1
Types and localizations of urethral strictures in studied groups A and B—results of tests from both groups
Fig. 2
Fig. 2
Values of maximum urine flow Qmax in both groups during consecutive observation stages—results of the Mann–Whitney test
Fig. 3
Fig. 3
Urine retention (R) in both groups during consecutive observation stages—results of the Mann–Whitney test
Fig. 4
Fig. 4
Evaluation of significance of changes in maximum urine flow rate (Qmax) during consecutive observation stages in group A—results of Friedman test
Fig. 5
Fig. 5
Evaluation of significance of changes in urine retention (PVR) during consecutive observation stages in group A—results of Friedman test
Fig. 6
Fig. 6
Evaluation of significance of changes in maximum urine flow rate (Qmax) during consecutive observation stages in group B—results of Friedman test
Fig. 7
Fig. 7
Evaluation of significance of changes in urine retention (R) during consecutive observation stages in group B—results of Friedman test
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