Comparison of treatment results between holmium laser endourethrotomy and optical internal urethrotomy for urethral stricture
Comparison of treatment results between holmium laser endourethrotomy and optical internal urethrotomy for urethral stricture
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DOI：
10.1007/s11255-011-0094-8
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发表时间：
2012-06-01
影响因子：
2
通讯作者：
Wroblewski, Mariusz
中科院分区：
文献类型：
--
作者：
Dutkiewicz, Slawomir A.;Wroblewski, Mariusz
我们比较了使用钬激光尿道内切开术（HLU）或光学尿道内切开术（OIU）治疗尿道狭窄（US）的结果、疗效和并发症，因为此类研究在文献中很少。在2003-2008年期间，50名年龄在17-78岁的男性接受了原发性或难治性US手术，分别为32例（64%）和18例（36%）患者。狭窄长度平均为1.86cm。分别有41例（82%）和9例（18%）患者的单发或多发性尿道狭窄，分别有27例（54%）和32例（64%）患者位于前尿道或后尿道。超声诊断为医源性32例（64%），特发性18例（36%）。患者被分为两组，grpA和grpB，每组25名患者分别使用HLU或OIU治疗。采用1-3级评价量表，并考虑最大流速（Q（max））、残余尿量（PVR）和生活质量（QL）。1分为非常好，2分为好，3分为差。分别在3个月、6个月和12个月后评价治疗结果。grpA的评价如下：5名（20%）、9名（36%）和7名（28%）患者评分为"1“; 13名（52%）、9名（20%）和4名（16%）患者评分为" 2”; 7名（28%）、11名（44%）和14名（56%）患者评分为"3“。grpB的评价：7例（28%）、10例（40%）和5例（20%）患者评分为"1“; 11例（44%）、7例（28%）和10例（40%）患者评分为" 2”; 7例（28%）、8例（32%）和10例（40%）患者评分为“3”。我们发现激光和传统尿道切开术都是安全有效的治疗方式。
We comparatively evaluated urethral stricture (US) treatment outcomes, efficacy and complications, using either holmium laser endourethrotomy (HLU) or optical internal urethrotomy (OIU) since studies such as this are scarce in literature.During 2003-2008, 50 men aged 17-78 years were operated on for primary or refractory US, 32 (64%) and 18 (36%) patients, respectively. The average stricture length was 1.86 cm. Strictures were single or multiple, forty-one (82%) and nine (18%) patients, respectively, and were located in the anterior or posterior urethra in 27 (54%) and 32 (64%) patients, respectively. US were iatrogenic in 32 (64%) and idiopathic in 18 (36%). Patients were divided into two groups, grpA and grpB, each containing 25 patients who were treated using either HLU or OIU, respectively. An evaluation scale of 1-3 was adopted and took maximum flow rate (Q(max)), postvoid residual (PVR), and quality of life (QL) into consideration. A score of '1 was very good, '2 was good, and '3 was poor.Treatment results were evaluated after 3, 6, and 12 months, respectively. Evaluation of grpA was as follows: five (20%), nine (36%), and seven (28%) patients scored a '1; thirteen (52%), nine (20%), and four (16%) patients scored a '2; and seven (28%), eleven (44%), and fourteen (56%) patients scored a '3. Evaluation of grpB: seven (28%), ten (40%), and five (20%) patients scored a '1; eleven (44%), seven (28%), and ten (40%) patients scored a '2; and seven (28%), eight (32%), and ten (40%) patients scored a '3.Neither complication rate nor degree of efficacy between HLU and OIU for US revealed a significant difference. We found both laser and conventional urethrotomies to be safe and effective modes of treatment.