Objective: We aimed to compare the ef- ficiency of cold knife urethrotomy and laser urethrotomy in endoscopic surgery of urethral strictures.
Material and Methods: A total of 171 patients were evaluated retrospectively. A 118 patients with complete data were divided into two groups (group 1; n = 53 cold knife ure- throtomy, group 2; n = 65 laser urethrotomy) in the study. Length of the stricture, operation time, preoperative and postoperative 3rd, 6th and 12th-month Qmax values, recurrence and the presence of complications (such as bleed- ing, extravasation, fever etc.) were compared in terms of the two groups.
Results: The operation time was found to be shorter in patients who underwent cold knife urethrotomy (14.01 ± 3.86 min vs 25.03 ± 4.43 min, p=0.001). The Q max values at the postoperative 3rd, 6th and 12th months were ob- served to be higher in patients who underwent laser urethrotomy (p=0.03, p=0.001, p=0.001). At the end of a one-year follow-up, recurrence was determined in 28 (52.83%) patients in group 1 and 12 (18.46%) patients had a recur- rence in group 2 (p=0.01). No statistically sig- nificant difference was observed between the two groups in terms of postoperative complica- tions. (p=0.209).
Conclusion: In this study, it was deter- mined that laser urethrotomy technique was a more successful surgical method than cold knife urethrotomy in the endoscopic surgery of urethral strictures as it has higher Qmax values and lower recurrence rate. The results should be supported by prospective, randomized studies.
Keywords: urethral strictures; laser urethrotomy; cold knife; nux.
Abstract
Objective: We aimed to compare the ef- ficiency of cold knife urethrotomy and laser urethrotomy in endoscopic surgery of urethral strictures.
Material and Methods: A total of 171 patients were evaluated retrospectively. A 118 patients with complete data were divided into two groups (group 1; n = 53 cold knife ure- throtomy, group 2; n = 65 laser urethrotomy) in the study. Length of the stricture, operation time, preoperative and postoperative 3rd, 6th and 12th-month Qmax values, recurrence and the presence of complications (such as bleed- ing, extravasation, fever etc.) were compared in terms of the two groups.
Results: The operation time was found to be shorter in patients who underwent cold knife urethrotomy (14.01 ± 3.86 min vs 25.03 ± 4.43 min, p=0.001). The Q max values at the postoperative 3rd, 6th and 12th months were ob- served to be higher in patients who underwent laser urethrotomy (p=0.03, p=0.001, p=0.001). At the end of a one-year follow-up, recurrence was determined in 28 (52.83%) patients in group 1 and 12 (18.46%) patients had a recur- rence in group 2 (p=0.01). No statistically sig- nificant difference was observed between the two groups in terms of postoperative complica- tions. (p=0.209).
Conclusion: In this study, it was deter- mined that laser urethrotomy technique was a more successful surgical method than cold knife urethrotomy in the endoscopic surgery of urethral strictures as it has higher Qmax values and lower recurrence rate. The results should be supported by prospective, randomized studies.
Keywords: urethral strictures; laser urethrotomy; cold knife; nux.