The Study Of Clinical Application Of Combined Holmium Laser Incision With Electro-incision For Urethral Stricture

Objective:To summarize the clinical experience of combined holmium laser incision with electro-incision in urethral stricture. The safety and effectiveness (curative effect) of this treatment was evaluated carefully by urologists, in order to find the key factors in treatment. Moreover, the key points of surgical treatment and clinical treatment suggestion, were discussed in this investigation in order to improve clinical efficacy.Methods:We studied118consecutive patients of urethral stricture from March2005to October2011. All of them were treated with Holmium laser incision with electro-incision. Perioperative and postoperative data in which included operation time, the time of indwelling catheter use, maximum flow rate (MFR) before or after operation, postoperative complications and the follow-up to the incidence of narrow, the operation of the perioperative preparation, surgical methods, the do’s and don’ts during and after surgery and prevention and control, were recorded by an experienced urologist. Among them (1cm＜X≤2cm) of random20cases of patients with urinary catheter remoal after urethral expansion, the outpatient regularly to follow-up. Relevant data were analysed using basic statistics.Results:All these cases, which X≤0.5cm, were cured;19of36cases (0.5cm (X≤1cm) were cured, about17cases’urethral stricture were returned, and7of them were operated by urethroplasty,10cases were treated with Holmium laser incision with electro-incision again;17of42cases (1cm (X≤2cm) cases were cured, and others were undergone urethroplasty (n=16) or Holmium laser incision with electro-incision (n=9). After urinary catheter removal,20patients were regularly treated by dilation of urethra in two months, other cases were not treated by dilation of urethra. There is no significant difference between them;5of17cases with urethral stricture in which longer than2cm were cured by Holmium laser incision with electro-incision, others were undergone urethroplasty (n=5) or vesicostomy (n=7). Conclusion:1、Combined Holmium laser incision with electro-incision treatment urethral stricture is safe and effective treatment for urethral stricture. There is a significant correlation between curative effect and the length of the urethral stricture, X≤0.5cm is the best indication for Holmium laser incision with electro-incision;0.5cm (X≤1cm is partly indication for Holmium laser incision with electro-incision; when1cm(X≤2cm, open surgery were preferred; Especially for ones whose X>2cm, with many place urethral stricture or already undergone open surgery, secondly open surgery is very difficult, Holmium laser incision with electro-incision could be tried in these patients.2、For some partly urethral stricture patients, dilation of urethra might be only a temporary treatments.