Portal de Periódicos da CAPES

Holmium:YAG Laser for Treatment of Strictures of Vesicourethral Anastomosis after Radical Prostatectomy

2005; Mary Ann Liebert, Inc.; Volume: 19; Issue: 4 Linguagem: Inglês

10.1089/end.2005.19.497

1557-900X

Brunolf W. Lagerveld, M. Pilar Laguna, F.M.J. Debruyne, Jean de la Rosette,

Prostate Cancer Diagnosis and Treatment

Strictures of the vesicourethral anastomosis (VUA) following radical prostatectomy tend to recur. We used the holmium:YAG laser for treatment of recurrent stricture of the VUA. We evaluated the technique and its efficacy.In 10 patients, the Ho:YAG laser was used with a 365-mum fiber at a setting of 2 J and frequency 10 to 20 Hz, creating a deep incision of the scar tissue at the 6 o'clock position. This was followed by a vaporizing resection of the remaining scar tissue between 3 and 9 o'clock. We aimed to vaporize up to well-vascularized surrounding tissue. Retrospectively, the charts were reviewed for hospital stay, voiding complaints, recurrence of stenosis, complications, and flow rates. The mean follow-up was 18 months.There were no operative complications. After removal of the catheter, all patients could void without difficulty. No re-treatment was needed for recurrent stenosis. Any existing irritative voiding complaints or incontinence did not change after treatment. In all patients, the flow pattern improved: the mean maximum flow rate increased, and the mean postvoiding residual volume decreased.The Ho:YAG laser seems to be a safe and effective treatment for first or recurrent strictures of the VUA after radical prostatectomy.