Results

Several studies analyze the use of the Nd/YAG [14, 15, 18, 108, 112, 113, 124] as well as the argon [2, 11], holmium [23, 59], and the CTP lasers [54, 109, 121] in the treatment of urethral strictures.

The difficulty in comparing these studies stems from the different electric power used in different periods of time. Moreover, the surgical techniques vary, as some prefer a simple incision, others a treatment of the total circumference. The number of patients also varies between 6 and 57, the follow-up between 0 and 53 months.

In tests with the Nd/YAG laser, the success rate was between 36% [112] and 100% [109]. After treatment with the CTP laser, there were reports of success rates of 59% [122] to 83% [54]. Treatment with the argon laser showed a lasting success with 78% of the patients [2]. Contrary to this, Becker et al. found, after an average follow-up of 15.2 months with 450 patients, a urethral relapse of 70.1% after argon therapy. Nearly 50% of these relapses appeared within the 1st year [11]. The main complication was urethral perforation [108], infection of the mucous membrane of the rectum [108], as well as urethral skin fistula [109].

Patients with short strictures had just as low relapse rates after laser treatment (4%) as with traditional Sachse urethrotomy [15]. Patients with extensive strictures also showed relapse rates of 77% with laser treatment [15].

Vincente et al. [124] reported of a random study on 30 patients with urethral strictures, who had either been treated by conventional internal urethrotomy or Nd/YAG laser. The patients were re-examined by means of clinical examination with the help of ┬╗uroflow┬ź and miction cys-tourethrography. The urethrotomy group had a success rate of 80% after 1 year and 60% after 2 years. The laser group showed a satisfactory result for 73% of the patients after the 1st and 2ndyear. The differences were not of statistical significance.

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