Comparison Of The Rapeutic Effect Between Holmium Laser Combined Ureteroscopy And Cold Knife Urethrotomy For Male Simple Urethral Stricture

[Objective]To assess the effectiveness of visual laser ablation treatment with holmium-doped yttrium aluminum garnet (Ho:YAG) laser in male patients with simple urethral strictures and to compare the effects with those obtained in patients treated with Sachse’s optical urethrotomy.[Methods]Retrospectively analyze68patients who were diagnosed with male simple urethral stricture from Jan2008to Feb2013in Yuncheng Central Hospital. The patients were divided into two groups:37men treated using visual laser ablation of urethral strictures with Ho:YAG laser(A group) and31men treated by correction of urethral strictures using Sachse’s optical cold knife urethrotomy. The significant markers and therapeutic results were recorded and analyzed, which includes the demographics of patients (Age、Positi on、Length、Qmax),the operating time, the bloodloss, Qmax, the complication before operation, recurrence Re-operation, the complication after operation. The therapeutic effects were compared in the two groups.[Result]1. The operation time of each group (the group of Holmium, the group of cold knife urethrotomy)which was used to treat posterior-urethral stricture and atresia,were38.1±8.7min、20.3±5.5min separately. The blood loss were19.8±5.8ml、31.3±8.5ml separately. The difference between the two groups were significant(P<0.05). 2.34cases of A group were followed up for4to30months, average14months, and28cases of B group were followed up for6to35months, average16months. The number of time for urethra dilation of each group (the group of Holmium, the group of cold knife urethrotomy) were11.1±3.1、16.1±4.9. The Qmax were19.2±3.4ml/s,15.1±2.9ml/s. The recurrence were6(17.6%)、9(32.1%). The re-operation were3(8.8%)、6(24.1%). The difference between the two groups were significant(P<0.05).3.No urinary extravasation cases in A group,no urinary incontinence patients after operation;2cases of urinary extravasation cases in B group,1cases of posto-perative urinary incontinence patients.[Conclusion]VLASU can be used as a method of treatment of this disorder. It is an effective, modem, low-invasive, low-blood loss and repeatable technique and is technically sim-ple and easy to master. It can be used for treatment of multiple strictures during one procedure. The choice of VLASU as a method of treatment significantly decreased the probability of therapeutic failure and recurrence of urethral strictures. The treatm-ent is more effective than transurethral resection of the cold knife incision, but the opration time is longer.