Comparison of Holmium Laser versus Cold Knife Treatment in Patients with Urethral Strictures
DOI:
https://doi.org/10.51985/Keywords:
urethral stricture, holmium laser, urethrotomyAbstract
Objective: The goal of this study is to assess the efficacy of optical internal urethrotomy, which uses a holmium laser in comparison to a cold knife, in treating short-segment urethral strictures in our local setting.
Study design & Settings: Randomized controlled trial (ClinicalTrials.gov Identifier: NCT07505316) at the Department of Urology, Kidney Center- Bahawal Victoria Hospital, Bahawalpur.
Methods: Males aged 18 to 70 years with short segment urethral strictures (length <2 cm), planned to undergo internal urethrotomy were included. Patients with multiple or recurrent strictures, active urinary tract infections, complete urethral obliteration on urethroscopy, with pan-anterior strictures, posterior stenosis, failed prior interventions, were not included. Patients were randomly divided into group A (cold-knife) and group B (holmium laser) through lottery method using sealed opaque envelopes. Post procedure uroflowmetry was performed after 30 days and assessor was not aware of procedures performed
Findings: The mean Qmax of the holmium laser group was 18.9 +/- 3.5 ml/sec 30 days after surgery, as compared to the cold-knife group (14.8 +/- 3.2 ml/sec). This was found to be very statistically significant (p < 0.001), which indicated that the cold-knife method did not significantly enhance the urine flow rate compared to holmium laser urethrotomy. Conclusion: In individuals with short-segment urethral strictures, cold-knife and holmium laser urethrotomy both significantly increase urine flow, but the traditional method of holmium laser urethrotomy has a significantly higher post-operative Qmax.
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