Adamakis et al. Journal of Medical Case Reports 2012, 6:94 http://www.jmedicalcasereports.com/content/6/1/94 Page 3 of 5 Figure 2 Pediatric resectoscope. seemed to be an attractive choice for the treatment of the UVA stenosis at our patient’s first visit, since the stricture was detected early and the scarring process was still limited. Furthermore, the role of the transurethral incision remains highly debatable. A two-stage approach with Urolume stenting of the contracture prior to an AUS has been reported with acceptable outcomes [3,10]. A recent study by the Baylor College of Medicine reported a 17-month satisfaction rate of 89% in nine patients [3]. Placement of a Urolume stent however, is not without complications, such as migration, hematuria, encrustation and re-obstruction due to the hyperplastic tissue ingrowth [3,14]. Moreover, the extraction of this stent can be very difficult for the urologist due to catastrophic effects to the urethral tissue. An excellent review by Bader and colleagues has sum- marized Ho:YAG laser use [15]. The reviewed studies were neither randomized nor prospective, and the patient cohorts and the follow-up periods were limited [4,16,17]. The Ho:YAG laser is safe and easy to handle and was reported to have a success rate of 83% in a ser- ies of 24 patients [4]. Under direct vision a controlled incision and vaporizing of the scar tissue can be per- formed [18]. The end-firing fiber of the holmium laser is light and flexible and can be used with a rigid and a flexible endoscope, due to its small caliber. Although the physical characteristics of this laser type are advan- tageous, due to minimal tissue penetration and accurate targeting, safe conclusions about its efficacy and effec- tiveness cannot be drawn. Figure 3 Pediatric resectoscope during resection.