Evaluation of holmium laser versus cold knife in optical internal urethrotomy for the management of short segment urethral stricture.

OBJECTIVES: SACHSE COLD KNIFE IS CONVENTIONALLY USED FOR OPTICAL INTERNAL URETHROTOMY INTENDED TO MANAGE URETHRAL STRICTURES AND HO: YAG laser is an alternative to it. The aim of this study was to evaluate the role of urethral stricture treatment outcomes, efficacy, and complications using cold knife and Ho: YAG (Holmium laser) for optical internal urethrotomy. MATERIALS AND METHODS: In this prospective study included, 90 male patients age >18 years, with diagnosis of urethral stricture admitted for internal optical urethrotomy during April 2010 to March 2012. The patients were randomized into two groups containing 45 patients each using computer generated random number. In group A (Holmium group), internal urethrotomy was done with Holmium laser and in group B (Cold knife group) Sachse cold knife was used. Patients were followed up for 6 months after surgery in Out Patient Department on 15, 30 and 180 post-operative days. At each follow up visit physical examination, and uroflowmetry was performed along with noting complaints, if any. RESULTS: The peak flow rates (PFR) were compared between the two groups on each follow up. At 180 days (6 month interval) the difference between mean of PFR for Holmium and Cold knife group was statistically highly significant (P < 0.001). Complications were seen in 12.22% of cases. CONCLUSION: Both modalities are effective in providing immediate relief to patients with single and short segment (<2 cm long) urethral strictures but more sustained response was attained with Cold knife urethrotomy.

Primary mesenteric liposarcoma: An unusual presentation of a rare condition.

Primary mesenteric liposarcoma is a rare neoplasm. Here, we report the case of a 50 year old Indian man with a pleomorphic liposarcoma of the mesentery. The clinical findings pointed towards a retroperitoneal growth but imaging resolved the issue. A laparotomy was performed and a 20 cm × 20 cm multilobulated tumour arising from the mesentery and weighing 1.8 kilograms was excised with a segment of jejunum. The cut surface had a variegated appearance with regions of necrosis. The histological features were suggestive of pleomorphic liposarcoma. Tumour cells were positive for S-100 and negative for SMA/Desmin. Complete resection is curative although the role of chemotherapy remains to be established.