Treatment of Urethral/Bladder Neck Stricture After High-Intensity Focused Ultrasound for Prostate Cancer With Holmium: Yttrium-Aluminium-Garnet Laser.
- Author:
Won Jin CHO
1
;
Tae Heon KIM
;
Hyo Serk LEE
;
Jin Woo CHUNG
;
Ha Na LEE
;
Kyu Sung LEE
Author Information
1. Department of Urology, Chosun University Hospital, Chosun University School of Medicine, Gwangju, Korea.
- Publication Type:Original Article
- Keywords:
Transrectal high-intensity focused ultrasound;
Holmium;
Prostate neoplasms;
Urethral stricture;
Urinary bladder neck obstruction
- MeSH:
Constriction, Pathologic;
Follow-Up Studies;
Holmium;
Humans;
Lasers, Solid-State;
Medical Records;
Neck;
Prostate;
Prostatic Neoplasms;
Quality of Life;
Residual Volume;
Retrospective Studies;
Ultrasound, High-Intensity Focused, Transrectal;
Urethral Stricture;
Urinary Bladder;
Urinary Bladder Neck Obstruction;
Urinary Incontinence;
Urinary Sphincter, Artificial
- From:International Neurourology Journal
2013;17(1):24-29
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: To evaluate the efficacy and safety of the Holmium: yttrium-aluminium-garnet (YAG) laser for the treatment of urethral/bladder neck strictures after high-intensity focused ultrasound for prostate cancer. METHODS: Between February 2007 and July 2010, Holmium: YAG laser urethrotomies were performed in eleven patients for bladder neck strictures or prostatic urethral strictures. The laser was used with a 550-microm fiber at 2 J and frequency 30 to 50 Hz. The medical records were retrospectively reviewed for medical history, perioperative and postoperative data, uroflowmetry, International Prostate Symptoms Score/quality of life, and stricture recurrence. RESULTS: At a median follow-up of 12.0 months (range, 4 to 35 months), the mean postoperative maximal flow rate and residual volume were improved significantly (P<0.05). The mean postoperative total, voiding and quality of life of international prostate symptom score were improved significantly (P<0.05). Of the 11 patients, 7 patients required one treatment, 4 patients two treatment, and 1 patients three treatment. 2 patients who had a documented urinary incontinence prior to the laser treatment subsequently required artificial urinary sphincter implantation and reported satisfaction without developing any recurrent strictures or artificial urinary sphincter erosion. All patients exhibited well-healed strictures and could void without difficulty. CONCLUSIONS: Holmium: YAG laser therapy represents a safe, effective and minimally invasive treatment for urethral/bladder neck strictures occurring secondary to high-intensity focused ultrasound for prostate cancer.
