Comparison Of Combined Holmium Laser Incision With Electro-incision And The Open Surgery In The Treatment Of The Latter Urethral Stricture

Objective: To compare the clinical efficacy and safety of combined holmium laser incision with electro-incision and the open surgery for the latter urethral stricture and close.Methods: A total of 40 patients who were diagnosed with urethral stricture and atresia from Sep 2005 to Oct 2007 in the first affiliated hospital of Nanchang university were divided into two groups.18 cases of urethral stricture were taken combined therapy with holmium laser incision and electro-incision (combined therapy group),while another 22 case of urethral stricture patients were taken traditional open surgery(traditional therapy group).All patients were followed up for 6 to 12 month average 9 months. The significant markers and therapeutic results were recorded and analyzed,which includes operating time,the blood loss,the time of Foley catheters indwelled, the number of time for urethra dilation, the cure rate and secondary complications such as bleeding, urine leakage.The therapeutic effects were compared in the two groups.Results:1. The operation time of each group(the group of combined holmium laser incision and electro-incision , the group of open operation) which was used to treat posterior-urethral stricture and atresia were 48.3士7.2min,129.3士4.3min separately. The blood loss were <25ml,256.7士12.3mlseparately. The differences between the two group were significant (P<0.01).2. The time of Foley catheters indwelled for each group ((the group of combined holmium laser incision and electro-incision,the group of open operation) which was used to treat posterior-urethral stricture and atersia were14.3士1.4d,30.7士5.4d separately, the times in hospital were17.3士5.8d,24.7士4.1d separately. The differences between the two groups were significant (P<0.05).3. 40 eases were followed up for 6 to12 months,average follow-up perd were 9 months. The number of time for urethra dilation of each group (the group of combined holmium laser incision and electro-incision,and the group of open operation ).were17.7士1.4 and 14.5士1.21,No significant differences were found between the two groups(p>0.05). There were 0 cases of incontinence of urine and 0 cases of impotence in the group of combined holmium laser incision and electro-incision. There were l ease of incontinence of urine and 3 cases of impotence in the open operation group.4. In the 18 cases of combined therapy group, 15 cases were cured successfully and the cure rate of the latter urethral stricture is 83.3%; In the 22 open operation fowllowed up, 19 cases were all successful operation, the cure rate of the latter urethral stricture is 86.3%, there was no significant difference between them. Conclusions:Urethrotomy should be considered as the first choice for simplex urethrostenosis especially with combined holmium laser incision and electro-incision. Open surgical operation is the final treatment and is better for complex urethral stricture.