1167: Holmium Laser Ablation of Urethral Strictures

Bordeau, Kevin P.; McCammon, Kurt; Jordan, Gerald H.

doi:10.1016/s0022-5347(18)38404-0

Cited by 3 publications

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“…The Ho:YAG laser achieves its main effect through a photomechanical tearing and subsequent vaporization of the of tissue at the surface [12]. The Ho:YAG laser with a tissue penetration of ≈0.5 mm and favourable cutting properties has been used for visual urethrotomy with promising short‐term results [13]. Injection of steroids at the incision sites ostensibly prevents scar formation by enhancing endogenous collagenase and thus reducing contracture rates [14–16].…”

Section: Discussionmentioning

confidence: 99%

Management of recurrent anastomotic stenosis following radical prostatectomy using holmium laser and steroid injection

et al. 2008

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OBJECTIVE To present our experience with the management of recurrent and resistant anastomotic stenosis following radical prostatectomy (RP) using transurethral laser incision of the stenotic area and injection of steroids. PATIENTS AND METHODS Between January 1999 and April 2006, we evaluated 24 patients with anastomotic stenosis that would not allow the passage of the flexible cystoscope (17 F). Using the paediatric 7.5 F Olympus scope and a 550‐µm fibre holmium laser, deep incisions were cut at the 3 and 9 o’clock positions at the bladder neck, and then triamcinolone was injected at the incision sites. Another session was then scheduled for office cystoscopy 6 weeks later, and if that showed evidence of annularity, another incision was made, as described above. RESULTS All 24 patients had RP for localized disease, 21 were retropubic and two were perineal, and one laparoscopic. Five patients had adjuvant radiotherapy. The mean patient age was 64 years. Nineteen (79%) patients had previous attempts to open the bladder neck: eight patients had dilatation, eight patients had internal urethrotomy, five patients underwent transurethral resection of the bladder neck, and six patients had open surgical intervention. The procedure was done once in 17 patients, and twice in seven patients. After a mean (range) follow up of 24 (6–72) months, 19 patients (83%) had a well‐healed and widely patent bladder neck. Of the 24 patients, 17 had urinary incontinence (UI) associated with the bladder neck contracture. An artificial urinary sphincter was implanted in 11 patients, three of which had to be explanted for malfunction in two, and erosion in one. CONCLUSION Holmium laser bladder neck incision and steroid injection for anastomotic stenosis after RP had a success rate of 83% in this small series. It can be used safely as a primary treatment, or in some cases, for resistant and recurrent stenosis. It appears that insertion of an artificial sphincter can be done in patients with UI when the bladder neck remains patent for at least 8 weeks.

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Section: Discussionmentioning

confidence: 99%

Management of recurrent anastomotic stenosis following radical prostatectomy using holmium laser and steroid injection

et al. 2008

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“…Ho:YAG laser urethrotomy is a safe and effective minimally invasive therapeutic modality for urethral stricture with results comparable to those of conventional urethrotomy [ 4 ]. In intervention for recurrent urethral stricture holmium laser treatment is safe and effective [ 5 ]. Application of steroid at time of urethrotomy produces better result than urethrotomy alone [ 5 , 6 ].…”

Section: Introductionmentioning

confidence: 99%

“…In intervention for recurrent urethral stricture holmium laser treatment is safe and effective [ 5 ]. Application of steroid at time of urethrotomy produces better result than urethrotomy alone [ 5 , 6 ]. Mitomycin C is useful in delaying the healing process by preventing replication of fibroblasts and epithelial cells and inhibiting collagen synthesis.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Optical Internal Urethrotomy and Intralesional Injection of Vatsala-Santosh PGI Tri-Inject (Triamcinolone, Mitomycin C, and Hyaluronidase) in the Treatment of Anterior Urethral Stricture

Kumar

Garg

Singh

et al. 2014

Advances in Urology

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Purpose. To study the efficacy of optical internal urethrotomy with intralesional injection of Vatsala-Santosh PGI tri-inject (triamcinolone, mitomycin C, and hyaluronidase) in the treatment of anterior urethral stricture. Material and Methods. A total of 103 patients with symptomatic anterior urethral stricture were evaluated on the basis of clinical history, physical examination, uroflowmetry, and retrograde urethrogram preoperatively. All patients were treated with optical internal urethrotomy followed by injection of tri-inject at the urethrotomy site. Tri-inject was prepared by diluting the combination of triamcinolone 40 mg, mitomycin C 2 mg, and hyaluronidase 3000 in 5–10 mL of saline according to length of stricture. An indwelling 18 Fr silicone catheter was left in place for a period of 7–21 days. All patients were followed up for 6–18 months postoperatively on the basis of history, uroflowmetry, and, if required, retrograde urethrogram and micturating urethrogram every 3 months. Results. The overall recurrence rate after first OIU is 19.4% (20 out of 103 patients), that is, a success rate of 80.6%. Overall recurrence rate after second procedure was 5.8% (6 out of 103 patients), that is, a success rate of 94.2%. Conclusion. Optical internal urethrotomy with intralesional injection of Vatsala-Santosh PGI tri-inject (triamcinolone, mitomycin C, and hyaluronidase) is a safe and effective minimally invasive therapeutic modality for short segment anterior urethral strictures.

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World Journal of Pharmaceutical Sciences

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1167: Holmium Laser Ablation of Urethral Strictures

Cited by 3 publications

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Management of recurrent anastomotic stenosis following radical prostatectomy using holmium laser and steroid injection

Management of recurrent anastomotic stenosis following radical prostatectomy using holmium laser and steroid injection

Efficacy of Optical Internal Urethrotomy and Intralesional Injection of Vatsala-Santosh PGI Tri-Inject (Triamcinolone, Mitomycin C, and Hyaluronidase) in the Treatment of Anterior Urethral Stricture

World Journal of Pharmaceutical Sciences

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