The Clinical Study Of Balloon Dilation Combined With Holmium Laser To Treat Urethral Stricture

Objective:To investigate the clinical safety and efficacy of the application of balloon dilation combined with holmium laser to treat urethral stricture.Methods:A total of50patients who were diagnosed with urethral stricture from Sep2012to Feb2014in our center underwent balloon dilation combined with holmium laser. The significant markers and therapeutic results were recorded and analyzed, which included operating time, the blood loss, the time of Foley catheters indwelled, IPSS score, QQL score,Qmax, the cure rate, the operation of the perioperative preparation, surgical methods and postoperative complications. Relevant data were analyzed using basic statistics.Results:36procedures were performed successfully. The median operation time was45.7±4.8min (20to70min). The average blood loss was10ml(5to20ml).The time of Foley catheters indwelled was15.1±4.2d (3to29d).The Qmax were21.4±4.4,20.3±4.2and19.6±3.7ml/s.The IPSS score were8.7±2.3,8.1±1.6and8.4±2.3.The QQL score were 1.3±0.5,1.0±0.4and1.5±0.2. For the Qmax, IPSS and QoL score, significant differences were found between before and after operation (P<0.05).49cases were followed up for3to17months,11cases (X<lcm) were cured;19of25cases (1cm<X<3cm) cases were cured,6cases’ urethral stricture were returned, and3of them were regularly treated by dilation of urethra,3of them were treated by balloon dilatation combined with holmium laser again;6of13cases (X>3cm) cases were cured, others were undergone urethroplasty (n=5) or balloon dilatation combined with holmium laser again (n=2).In the treatment of simple urethral stricture,19of23cases were cured, the cured rate is82.6%; For complex. urethral stricture,17of26cases were cured, the cured rate is65.4%. There is significant difference between them (P<0.05). There were not serious complications in all patients.Conclusion:1. Balloon dilatation combined with holmium laser to treat urethral stricture has advantages of safety, effectiveness, minimal invasion, less complications and faster postoperative-recovery.2.There is a significant correlation between curative effect and the length of the urethral stricture:X<lcm, balloon dilatation combined with holmium laser is the best choice; lcm<X<3cm is partly indication for balloon dilatation combined with holmium laser; X>3cm, open surgery is preferred. 3. Balloon dilatation combined with holmium laser should be considered as the first choice for simple urethral stricture. It is a better method for the treatment of complex posterior urethral stricture.