Abstract

Mohammed A. Hussein*, Ghassan Abdulla Raddam and Ahmed Ali Abdul Hussein

ABSTRACT

Background: Urethral stricture is a prevalent condition associated with great morbidity which can be severe, jeopardizing the patient's quality of life (QoL). Aim: To study the efficacy and outcome of Holmium: YAG laser ablation of short urethral stricture compared to cold knife internal urethrotomy. Patients and methods: Thirty three adult male patient presented with urethral stricture less than two cm were randomly allocated into two groups; first group treated with Holmium laser (14 patient), the second group of patient treated with cold knife internal urethrotomy (19 patient). A careful evaluation with retrograde cystourethrogram and uroflowmetry were done on all patients, and they were followed up for one year with urine culture and sensitivity, RUG, and uroflowmetry. Results: The most common cause of urethral stricture in both groups was iatrogenic injury. The mean operative time of cold knife urethrotomy procedure was 27.4 minutes compared to 26.78 minutes in the Holmium laser group. Mean VAS of pain was 2 for laser treated patients and 2.15 for cold knife treated patients. Recurrence rate with need for redo surgery was seen in 3 cases in holmium group compared to 9 cases in the cold knife treated patients. Conclusion: Both holmium laser and cold knife internal urethrotomy are effective surgical options for the treatment of short urethral stricture less than 2 cm with a promising outcome after 1 year follow up with better success rate using the Holmium laser.