[PP-024]
Comparison of Cold-Knife Optical Internal Urethrotomy and Holmium:YAG Laser Internal Urethrotomy in Bulbar Urethral Strictures
Mustafa Gürkan Yenice, Kamil Gökhan Şeker, Emre Şam, Yunus Çolakoğlu, Feyzi Arda Atar, Selçuk Şahin, Abdulmuttalip Şimşek, Volkan TuğcuINTRODUCTION
Urethral strictures are still among the most common reasons of urology clinic admissions. Treatment options for urethral strictures include self-catheterization, bougie dilation, balloon dilation, urethral stent placement, cold-knife optical internal urethrotomy (OIU), laser urethrotomy methods and open reconstructive urethroplasty, which is generally reserved for cases who did not benefit from endoscopic approaches.
AIMS
The aim of this study is to compare pre- and post-operative uroflowmetry results and operations characteristics of OIU and Ho:YAG laser approaches in bulbar urethral strictures.
MATERIALS AND METHODS
A total of 63 patients diagnosed with primary bulbar urethral stricture between August 2014 and September 2015 were assigned to the OIU (n = 29) and HIU (n = 34) groups. The demographic variables, biochemistry panels, and preoperative and postoperative uroflowmetry (UF) results including the maximum flow rate (Qmax) and mean flow rate (Qmean) values, retrograde urethrography, and diagnostic flexible urethroscopy findings were recorded prospectively.
RESULTS
Overall mean age was 55.1 ± 9.1 years. Demographic features and preoperative values were not statistically different between groups (p > 0.05). Mean surgical times were 18.4 ± 2.3 min for OIU and 21.9± 3.8 min for HIU groups, which was statistically significant (p < 0.05). The total complication rate was 3.4% in the OIU group, and 8.8% in HIU the group. There was no significant difference in complication rates in both groups (p = 0.618). Postoperative Qmax values were increased in both groups even though postoperative Qmax values were not significantly different between the two groups in the short- and long-term results at 3, 6, and 12 months (p > 0.05). There was no recurrence in the first 3 months in both groups. The urethral stricture recurrence rate up to month 12 was not statistically significant for the OIU group (n = 6, 20.7%) compared with the HIU group (n = 11, 32.4%; p = 0.299).
CONCLUSIONS
Holmium:YAG laser internal urethrotomy is an alternative method to cold-knife optical internal urethrotomy, and it has similar success rates in the treatment of short segment bulbar urethral strictures.
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Comparision of the preoperative and postoperative parameters