The use of a thulium laser in the treatment of urethral stricture.
Authors:   Urological department of State budgetary institution of the Republic of Dagestan «City Clinical Hospital», Katibov M.I. ,   Makhachkala, Russia, Bogdanov A.B. ,   Urological department of S.P. Botkin City Clinical Hospital, Associate Professor of Department of Urology and Surgical Andrology of Federal State Budgetary Educational Institution of Further Professional Education «Russian Medical Academy of Continuous Professional Education» of the Ministry of Healthcare of the Russian Federation; Moscow, Russia, Alibekov M.M. ,   Urological department of State budgetary institution of the Republic of Dagestan «City Clinical Hospital», Assistant of Department of Urology of Federal State Budgetary Educational Institution of Higher Education «Dagestan State Medical University» of the Ministry of Healthcare of the Russian Federation; Makhachkala, Russia, Magomedov Z.M. ,   Urological department of State budgetary institution of the Republic of Dagestan «City Clinical Hospital», Assistant of Department of Surgical Diseases of the Pediatric, Dental and Preventive Medicine Faculties of Federal State Budgetary Educational Institution of Higher Education «Dagestan State Medical University» of the Ministry of Healthcare of the Russian Federation; Makhachkala, Russia, Savzikhanov R.T. ,   Department of Urology of Federal State Budgetary Educational Institution of Higher Education «Dagestan State Medical University» of the Ministry of Healthcare of the Russian Federation; Makhachkala, Russia
Published: August 2024

Introduction. The thulium laser is relatively recently used in the treatment of various urological diseases. Only a few studies report the use of thulium laser urethrotomy for urethral strictures. The purpose of this study was to evaluate the results of the use of a thulium laser for the treatment of urethral strictures. Materials and methods. A prospective, observational, uncontrolled study included 45 men with urethral stricture, aged 43 to 85 years (median, 65 years), who underwent thulium laser urethrotomy. The length of the stricture ranged from 0.5 to 2.5 cm (median 1.2 cm). A laser fiber with a length of 200 μm was used at an energy of 0.5 J and a power of 10 W. The success of the treatment was considered the absence of complaints of difficult urination in combination with a maximum urination rate of more than 15 ml/s and no or insignificant amount of residual urine (less than 50 ml). The dynamics of various parameters after surgery were assessed using the Wilcoxon test. The difference between the indicators was considered significant at p<0.05. Results. Postoperative follow-up time ranged from 3 to 48 months (median 18 months). With these follow-up periods, treatment was successful in 32 (71.1%) patients. A significant improvement in the median of the following indicators for the entire group of patients after surgical treatment com- pared with preoperative data was established: maximum urination rate – from 9.2 to 21.1 ml/s (p=0.024); average urination rate – from 4.5 to 10.3 ml/s (p=0.025); residual urine volume – from 110 to 42 ml from 9.2 to 21.1 ml/s (p=0.014); indicators of the IPSS questionnaire – from 20 to 7 points (p=0.011); quality of life according to the IPSS questionnaire – from 5 to 2 points (p=0.017). There were no intraoperative complications. Of the postoperative complications, only urinary tract infection was noted in 5 (11.1%) patients. Conclusions. Thulium laser urethrotomy is a fairly safe and effective method for the treatment of short urethral strictures, regardless of the nature, etiology and localization of the cicatricial process. A small number of observations and a short period of postoperative observations in the world literature dictate the need to continue such scientific research.