980-nm diode laser treatment for recurrent urethral strictures

Objectives: Our experience with laser treatment of urethral strictures with a 980-nm diode laser is reported. Methods: 45 consecutive patients with re lapsing urethral strictures (mean age 65, range 25-85 years) were treated b etween February 1995 and February 1998. The fibrous and scar tissue was cut and vaporized at the 6 o'clock position with the laser beam, Results: 44/4 5 patients were available for follow-up at 1 year and 32/43 at 2 years. At 12 months the average peak flow rates of the patients was 18 ml/s, and at t he second year assessment it was 15.5 ml/s. Of the patients 21/44 (47.7%) w ere extremely satisfied (0-1 of the quality-of-life, QoL, assessment index) with the procedure, 14/44 (31.8%) were satisfied (2 of the QoL assessment index), and 9/44 (20.4%) were not satisfied (greater than or equal to 3 of the QoL assessment index) due to the low flow rate or the recurrence of the stricture. (The sum of the first two categories is 79.5%.) At the second y ear assessment the percentage of satisfied patients reached 78%, with 71% o f the patients stable without any dilatation. Conclusions: Usually in recur rent strictures of the urethra open surgery is suggested, but we believe th at there is still a place for endoscopy. With the laser we can make an inci sion at the 6 o'clock position without significant bleeding, very easily op ening the urethra, We had 79.5 and 71% good results at the 1- and 2-year as sessments (mean peak flow rate of 18 and 15.5 ml/min), respectively. To dat e, no definitive conclusions can be drawn, but we believe that laser treatm ent is indicated for recurrent strictures in high risk or elderly patients and in those who demand a minimally invasive procedure. Copyright (C) 2001 S. Karger AG, Basel.