Clinical Comparison Of Open Surgery And Transurethral Laser Treatment Of Post-traumatic Posterior Urethral Stricture Of Male

Objective: To evaluate and compare the Clinical effect of Open Surgeryand Transurethral Laser treating Post-traumatic posterior urethral stricture ofmale.Methods: By a retrospective study, the objects were the67male patientswith post-traumatic posterior urethral stricture receiving surgical treatment inthe Department of Urology First Hospital of Jilin University from January2006to June2012. Of which35cases were treated with traditional open surgerywhile urethral anastomosis, called the group of open operation, and32caseswere treated transurethral holmium laser incision, called the group of holmiumlaser incision. The basic data of the patients were gotten by looking up themedical records(including data or results of the standard preoperative andpostoperative urethroscopy, urography, urethral dynamics examination etc.),combined with face to face counseling or by telephone. Contents include: thepatient’s age status, duration of surgery method, surgical duration, intraoperativeblood loss, postoperative hospital stay, costs, restenosis. We compared theefficacy of two groups through statistical analysis.Results:1.The operative time of each group (the group of holmium laserincision, the group of open operation) which was used to treat malepost-traumatic posterior urethral stricture and atresia were209.5±72.3min,45.3±23.8min, separately. The blood loss in both groups were242.6±64.9ml， 23.1±10.5ml separately． The differences between the two groups weresignificant.(P＜0.05)2．The postoperative gastrointestinal recovery time of open surgery group,and holmium laser incision group were17.3±5.8h,11.4±4.1h, the postoperativehospitalization time of two groups were11.9±4.3d,4.7±2.5d separately．Thedifferences between the two groups were significant.(P＜0.05) Thehospitalization costs were14077.3±6188.3yuan,11426.4±2830.3yuanseparately，there were significant differences between the two groups.(P＜0.05)3．All cases were followed up for12months，the cases suffering restenosisin the open surgery group and holmium laser incision group, separately, were1case, accounting2.9%and10cases, accounting31.3%; there were significantdifferences between the two groups.(P＜0.05)For urethral stricture length≤1cm, restenosis rate was0.0%and5.0%separately, there was no significantdifference;(P＞0.05) for urethral stricture length between1cm and2.5cm,restenosis rate was4.8%and75.0%separately, there were significantdifferences between the two groups.(P＜0.01)4. Patients were followed up for12months, the open surgery group of35patients,34cases cured, accounting for97.1%, the laser incision group of32cases,22cases cured, accounting for68.7%, there were significant differencesbetween the two groups.(P＜0.05)Conclusion (1) Transurethral holmium laser incision surgery is a less injury,quicker recovery method, and suit for the treatment of the patients with simpleurethral stricture≤1cm or the patients who can not tolerate long time surgery operating.(2) Open surgery has obvious advantages, in treatment of men withtraumatic posterior urethral stricture and occlusion＞1cm and can significantlyreduce the recurrence rate of restenosis.(3) Open surgery is the best approachto posterior urethral stricture between1cm and2.5cm, especially to recurrentposterior urethral stricture.