Clinical Analysis and New Thinking of 200 μm Holmium Laser Fiber in the Treatment of Bulbar and Membranous Urethral Stricture
Objective:To evaluate the clinical efficacy of using 200 μm holmium laser fiber in the treatment of strictures of urethral bulb or membranous part.Methods:The clinical data of 86 male patients from January,2018 to June,2020 with urethral stricture treated by direct visual internal urethrotomy were analyzed retrospectively.All patients had a stenosed segment that was less than 1 cm and color Doppler ultrasound examination showed scar thickness was less than 0.5 cm.According to surgical methods the patients were divided into two groups.The control group(cold knife group,41 cases):the cold section was used to longitudinally the stenosed section until the junction of scar and normal tissue.The observation group(laser group,45 cases):200 μm holmium laser fiber longitudinally cut the narrow section coaxially until the junction of scar and normal tissue.After surgery the 16F silicone catheters were left for 2 weeks,their urination conditions were observed after removed.Results:The operation time of the laser group was longer,intraoperative and during operation loss is less,with statistically significant difference(t=8.494,15.112,14.351,13.300;P＜0.05).There was no significant difference between the two groups in self-urination immediately after surgery,3 months after surgery,12 months after surgery and maximum urine flow rate(t=0.130,0.528,0.298,0.312;P＞0.05).After two weeks surgery,the physiological,psychological,social,environmental and independent scores of patients in both groups were significantly higher than before surgery,and the observation group was higher than the control group,with statistically significant difference(t=13.416,5.429,14.367,9.426,5.529;P＜0.05).Conclusion:The use of fine 200 μm holmium laser fiber optic urethrotomy does not increase complications,and the postoperative quality of life is higher than that of cold knife.The evaluation of surgical efficacy requires comprehensive consideration of narrow length and scar thickness.
Direct visual internal urethrotomy200 μm holmium laser fiberStrictures of urethral bulb or membranous partCold knifeCurative effect
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