APPLICATIONS OF THE KTP LASER IN THE TREATMENT OF POSTERIOR URETHRAL VALVES, URETEROCELES, AND URETHRAL STRICTURES IN THE PEDIATRIC-PATIENT

Purpose: We describe our experience using the potassium titanyl phosph ate (KTP)-532 laser in treating posterior urethral valves, ureterocele s, and urethral strictures in the pediatric patient. Methods: A retros pective chart review was performed from 1987 to 1997 on a total of 33 pediatric patients who underwent retrograde endoscopic treatment for p osterior urethral valves (PUV), ureteroceles (UC), and urethral strict ures using a KTP-532 laser, Results: Overall, our success rate was exc ellent in the treatment of valves and ureteroceles. With a mean follow -up of three years in the PUV group, no urethral strictures or mictura tion abnormalities were seen. The majority of ureteroceles were decomp ressed and only half of our patients required an additional procedure. Our experience with urethral strictures, however, was not as promisin g, All of these patients ultimately required open urethral reconstruct ion. Conclusion: The desirable thermal characteristics of the KTP lase r, along with minimal complications and the availability of delicate p ediatric endoscopic instruments have made this operation optimally sui ted for treating posterior urethral valves and ureteroceles in infants . However, the advantages for treating urethral strictures in children with the laser still remains to be established.