Objectives: Our experience with laser treatment of urethral strictures with a 980-nm diode laser is reported. Methods: 45 consecutive patients with relapsing urethral strictures (mean age 65, range 25–85 years) were treated between February 1995 and February 1998. The fibrous and scar tissue was cut and vaporized at the 6 o’clock position with the laser beam. Results: 44/45 patients were available for follow-up at 1 year and 32/43 at 2 years. At 12 months the average peak flow rates of the patients was 18 ml/s, and at the second year assessment it was 15.5 ml/s. Of the patients 21/44 (47.7%) were extremely satisfied (0–1 of the quality-of-life, QoL, assessment index) with the procedure, 14/44 (31.8%) were satisfied (2 of the QoL assessment index), and 9/44 (20.4%) were not satisfied (≥3 of the QoL assessment index) due to the low flow rate or the recurrence of the stricture. (The sum of the first two categories is 79.5%.) At the second year assessment the percentage of satisfied patients reached 78%, with 71% of the patients stable without any dilatation. Conclusions: Usually in recurrent strictures of the urethra open surgery is suggested, but we believe that there is still a place for endoscopy. With the laser we can make an incision at the 6 o’clock position without significant bleeding, very easily opening the urethra. We had 79.5 and 71% good results at the 1- and 2-year assessments (mean peak flow rate of 18 and 15.5 ml/min), respectively. To date, no definitive conclusions can be drawn, but we believe that laser treatment is indicated for recurrent strictures in high risk or elderly patients and in those who demand a minimally invasive procedure.

Keywords:
Stricture, Diode, Laser, Urethra
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© 2001 S. Karger AG, Basel
2001
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