Low-power holmium:YAG laser urethrotomy for urethral stricture disease: Comparison of outcomes with the cold-knife technique
In this prospective randomized clinical trial, we aimed to evaluate the safety and efficacy of endourethrotomy with holmium:yttrium-aluminium-garnet (HO:YAG) laser and compare the outcomes with the conventional cold-knife urethrotomy. Fifty-one male patients with single, iatrogenic, annular strictur...
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| Format: | Article |
| Language: | English |
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Wiley
2011-11-01
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| Series: | Kaohsiung Journal of Medical Sciences |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1607551X11001343 |
| _version_ | 1811283314209718272 |
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| author | Mustafa Atak Hüsnü Tokgöz Bülent Akduman Bülent Erol İbrahim Dönmez Volkan Hancı Özlem Türksoy Necmettin Aydın Mungan |
| author_facet | Mustafa Atak Hüsnü Tokgöz Bülent Akduman Bülent Erol İbrahim Dönmez Volkan Hancı Özlem Türksoy Necmettin Aydın Mungan |
| author_sort | Mustafa Atak |
| collection | DOAJ |
| description | In this prospective randomized clinical trial, we aimed to evaluate the safety and efficacy of endourethrotomy with holmium:yttrium-aluminium-garnet (HO:YAG) laser and compare the outcomes with the conventional cold-knife urethrotomy. Fifty-one male patients with single, iatrogenic, annular strictures of the urethra were randomly divided into two groups; 21 patients who underwent direct-vision endoscopic urethrotomy with Ho:YAG laser (15 W; 1,200–1,400 mJ; 8–12 Hz) at 12 o’clock position (laser group) and 30 patients who underwent direct-vision endoscopic urethrotomy with cold-knife incision at 12 o’clock position (cold-knife group). The results obtained were analyzed and compared at 3 months, 6 months, 9 months, and 12 months postoperatively by clinical evaluation, uroflowmetry, and retrograde urethrographies. Variables were compared among groups using Fisher’s exact and Mann Whitney U tests. There were no differences between two groups in terms of patient age, preoperative Qmax value, stricture location, and length. Operative time was shorter in laser group (16.4±8.04 minutes) when compared with cold-knife group (23.8±5.47 minutes) (p<0.001). Recurrence-free rate at 3 months was similar between two groups (p=0.122). However, recurrence-free rates at 6 months, 9 months, and 12 months were significantly higher in laser group when compared with cold-knife group (p values were 0.045, 0.027, and 0.04, respectively). No intra- or postoperative complications were encountered. Use of Ho:YAG laser in the management of urethral stricture disease is a safe and effective method. In addition, it provides shorter operative time and lower recurrence rate when compared with the conventional technique. |
| first_indexed | 2024-04-13T02:09:12Z |
| format | Article |
| id | doaj.art-7ab72956fbb94058baa6acc018cc0518 |
| institution | Directory Open Access Journal |
| issn | 1607-551X |
| language | English |
| last_indexed | 2024-04-13T02:09:12Z |
| publishDate | 2011-11-01 |
| publisher | Wiley |
| record_format | Article |
| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj.art-7ab72956fbb94058baa6acc018cc05182022-12-22T03:07:21ZengWileyKaohsiung Journal of Medical Sciences1607-551X2011-11-01271150350710.1016/j.kjms.2011.06.013Low-power holmium:YAG laser urethrotomy for urethral stricture disease: Comparison of outcomes with the cold-knife techniqueMustafa Atak0Hüsnü Tokgöz1Bülent Akduman2Bülent Erol3İbrahim Dönmez4Volkan Hancı5Özlem Türksoy6Necmettin Aydın Mungan7Department of Urology, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, TurkeyDepartment of Urology, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, TurkeyDepartment of Urology, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, TurkeyDepartment of Urology, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, TurkeyDepartment of Urology, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, TurkeyDepartment of Anesthesiology, Faculty of Medicine, Karaelmas University, Zonguldak, TurkeyDepartment of Radiology, Faculty of Medicine, Karaelmas University, Zonguldak, TurkeyDepartment of Urology, Faculty of Medicine, Zonguldak Karaelmas University, Zonguldak, TurkeyIn this prospective randomized clinical trial, we aimed to evaluate the safety and efficacy of endourethrotomy with holmium:yttrium-aluminium-garnet (HO:YAG) laser and compare the outcomes with the conventional cold-knife urethrotomy. Fifty-one male patients with single, iatrogenic, annular strictures of the urethra were randomly divided into two groups; 21 patients who underwent direct-vision endoscopic urethrotomy with Ho:YAG laser (15 W; 1,200–1,400 mJ; 8–12 Hz) at 12 o’clock position (laser group) and 30 patients who underwent direct-vision endoscopic urethrotomy with cold-knife incision at 12 o’clock position (cold-knife group). The results obtained were analyzed and compared at 3 months, 6 months, 9 months, and 12 months postoperatively by clinical evaluation, uroflowmetry, and retrograde urethrographies. Variables were compared among groups using Fisher’s exact and Mann Whitney U tests. There were no differences between two groups in terms of patient age, preoperative Qmax value, stricture location, and length. Operative time was shorter in laser group (16.4±8.04 minutes) when compared with cold-knife group (23.8±5.47 minutes) (p<0.001). Recurrence-free rate at 3 months was similar between two groups (p=0.122). However, recurrence-free rates at 6 months, 9 months, and 12 months were significantly higher in laser group when compared with cold-knife group (p values were 0.045, 0.027, and 0.04, respectively). No intra- or postoperative complications were encountered. Use of Ho:YAG laser in the management of urethral stricture disease is a safe and effective method. In addition, it provides shorter operative time and lower recurrence rate when compared with the conventional technique.http://www.sciencedirect.com/science/article/pii/S1607551X11001343Cold knifeHo:YAGInternal urethrotomyLaserUrethral stricture disease |
| spellingShingle | Mustafa Atak Hüsnü Tokgöz Bülent Akduman Bülent Erol İbrahim Dönmez Volkan Hancı Özlem Türksoy Necmettin Aydın Mungan Low-power holmium:YAG laser urethrotomy for urethral stricture disease: Comparison of outcomes with the cold-knife technique Kaohsiung Journal of Medical Sciences Cold knife Ho:YAG Internal urethrotomy Laser Urethral stricture disease |
| title | Low-power holmium:YAG laser urethrotomy for urethral stricture disease: Comparison of outcomes with the cold-knife technique |
| title_full | Low-power holmium:YAG laser urethrotomy for urethral stricture disease: Comparison of outcomes with the cold-knife technique |
| title_fullStr | Low-power holmium:YAG laser urethrotomy for urethral stricture disease: Comparison of outcomes with the cold-knife technique |
| title_full_unstemmed | Low-power holmium:YAG laser urethrotomy for urethral stricture disease: Comparison of outcomes with the cold-knife technique |
| title_short | Low-power holmium:YAG laser urethrotomy for urethral stricture disease: Comparison of outcomes with the cold-knife technique |
| title_sort | low power holmium yag laser urethrotomy for urethral stricture disease comparison of outcomes with the cold knife technique |
| topic | Cold knife Ho:YAG Internal urethrotomy Laser Urethral stricture disease |
| url | http://www.sciencedirect.com/science/article/pii/S1607551X11001343 |
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