부분 요도협착에서 Holmium Laser를 이용한 내시경하 내요도절개술의 초기 경험
Initial Experience with Endoscopic Holmium: YAG Laser Urethrotomy for Incomplete Urethral Stricture
최상훈, 이용성, 최낙규, 김형주,
소속 상세정보
최상훈 ( Choi Sang-Hoon )
한림대학교 의과대학 비뇨기과학교실
이용성 ( Lee Yong-Seong )
한림대학교 의과대학 비뇨기과학교실
최낙규 ( Choi Nak-Gyeu )
한림대학교 의과대학 비뇨기과학교실
김형주 ( Kim Hyung-Joo )
한림대학교 의과대학 비뇨기과학교실
KMID : 0358320090500030246
Abstract
Purpose: Endoscopic holmium:yttrium-aluminum-garnet (Ho:YAG) laser urethrotomy is an alternative method in the management of urethral strictures. We report our initial experience in 15 cases of evaluating the therapeutic efficacy of the holmium laser for treating incomplete urethral strictures.
Materials and Methods: Endoscopic holmium laser urethrotomy was primarily performed on 15 patients with incomplete urethral stricture. Exclusion criteria were complete urethral stricture and previous treatment of urethral stricture. Retrograde urethrography and uroflowmetry were performed preoperatively and were carried out as follow-up studies postoperatively.
Results: Successful results without recurrence were achieved in 8 of 15 patients. When we classified the results by stricture length, the success rate was 80% in strictures less than 2 cm, whereas there was no therapeutic effect in strictures over 2 cm. When we classified the results by etiology, the number of successful results in strictures with an inflammatory, trauma, iatrogenic, or unknown cause was 2 (2/8), 3 (3/4), 2 (2/2), and 1 (1/1), respectively. In 7 patients who failed treatment, we repeated holmium laser urethrotomy in 5 patients and urethroplasty in 2 patients. No operative complications occurred in any patients.
Conclusions: Endoscopic holmium laser urethrotomy is a safe and effective minimally invasive therapeutic modality in cases of stricture less than 2 cm. Further data from long-term follow-up are necessary to compare the
success rate with that of conventional urethrotomy and urethroplasty.
키워드
Holmium;Urethral stricture;Internal urethrotomy
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