Pulsed thulium laser combined with pulsed thulium laser injection for the treatment of failed urethral anastomosis
10.13263/j.cnki.nja.2024.05.005
- VernacularTitle:优路铥激光结合曲安奈德腔内注射治疗尿道吻合术失败病例的疗效观察
- Author:
Jian LI
1
;
Da-Chao ZHENG
;
Hai-Jun YAO
;
Jin HUANG
;
Zhong-Lin CAI
;
Zhi-Kang CAI
;
Yan-Ting SHEN
;
Zhong WANG
Author Information
1. 上海市浦东新区公利医院泌尿外科男科学部,上海 200135
- Keywords:
pulsed thulium laser;
bipolar electrocautery;
posterior pelvic fracture urethral distraction defect;
urethral anastomosis
- From:
National Journal of Andrology
2024;30(5):419-423
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the clinical effect of pulsed thulium laser(PTL)combined with triamcinolone acetonide injection in the treatment of failed posterior urethral anastomosis(FPUA).Methods:This retrospective study included 35 male pa-tients treated in Gongli Hospital for failed posterior urethral anastomosis from January 2018 to December 2023.All the patients under-went direct-vision internal urethrotomy(DVIU)with transurethral PTL(the PTL group,n=15)or transurethral plasma(the TUP group,n=20),and all received intralesional injection of triamcinolone acetonide.We followed up the patients for a median of 21 months,recorded the age,length of urethral stricture,operation time,pre-and post-operative maximum urinary flow rate(Qmax),postoperative complications and recurrence of urethral stricture,and compared the data obtained between the two groups.Results:All the patients smoothly completed the treatment procedures.No statistically significant differences were observed in the age,length of urethral stricture,operation time and postoperative complications between the two groups(P>0.05).The median follow-up time for the thulium laser group and plasma group was 21.0 months(IQR 16.0-24.0)and 21.0 months(IQR 17.0-25.0),respectively,with a statistically significant difference observed in the maximum urine flow rate before and after surgery at the 12-month mark(P<0.01).No significant disparity was found in terms of relapse-free survival between the two groups(P=0.398)Conclusion:Pulsed thulium laser combined with triamcinolone acetonide injection can effectively maintain a short-term cicatricial stability of the ure-thral stricture and satisfactory urethral patency,obviously superior to plasmotomy as a remedial treatment of urethral stricture after failed posterior urethral anastomosis.
