Direct vision internal urethrotomy with application of holmium: YAG laser

ABSTRACT

Male urethral stricture is a complicated urologic disease that could be successfully treated using internal urethrotomy. Laser internal urethrotomy has been used in many cases with favorable outcome in many studies. Holmium YAG laser with its incisional properties on tissue is one of the laser types applied for internal urethrotomy. We present a 19 year-old male with history of aortic valve stenosis and metallic aortic valvoplasty on prescription of oral anti-coagulant therapy [Warfarin] who was a candidate for internal urethrotomy due to bulbar urethral stricture. Holmium laser core-through urethrotomy was performed for him. Internal urethrotomy was done using the ablative 50-watt Holmium YAG laser 2140 nm [manufactured by the Atomic Energy Organization of Iran [AEOI]]. No complication was observed intra- and post-operatively. After 6 months of followup no evidence of urethral stricture was observed. According to our study, Ho-YAG laser core through urethrotomy is a safe and effective procedure. It is a less invasive alternative to more complex urethroplasty procedures for patients with post-traumatic urethral stricture with high risk of urethral bleeding due to anti-coagulant therapy