Holmium Laser versus Cold Knife in Visual Internal Urethrotomy for Management of Short Segment Urethral Stricture

Document Type : Original Article

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Abstract

Background: Fibrosis in the urethral mucosa and surrounding tissues causes the urethral lumen to narrow, which is known as urethral stricture disease. Congenital or idiopathic conditions may be the cause.
Objective: This study aimed to evaluate the safety and efficacy of holmium laser versus cold knife in management of short segment urethral stricture.
Patients and Methods: A prospective study was conducted in the Department of Urology, Outpatient Clinic, Zagazig University Hospital through the period from October 2019 to June 2020. 34 male patients with short segment anterior bulbar urethral strictures were included. Patients were randomly allocated into two groups: Group A, (cold–knife group) Sachse cold knife was used for internal urethrotomy and group B, (holmium laser group), internal urethrotomy was done with holmium laser. Patients were followed up after the operation at 1, 3 and 6 months respectively.
Results: In our study there was recurrence at 6 months in both groups and we found that laser group had lower recurrence rate 2 patients (11.8%) than cold-knife group 3 patients (17.6%) with no significant difference between the two groups (P =0.25). Folly catheter (18 f) was inserted per urethra for approximate 5 to7 days for both groups without significant difference between them.
Conclusions: This study showed that holmium laser is a good alternative option forvisual internal urethrotomy (VIU) rather than cold-knife urethrotomy as Laser urethrotomy is effective, easy, has minimal invasive procedure and has advantage for shorter operative time and less occurrence perioperative complications.
 

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The Egyptian Journal of Hospital Medicine
Volume 91, Issue 1
April 2023
Pages 4896-4902

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