Thulium laser treatment of benign bladder neck stenosis

Abstract

Introduction. High recurrence rate of bladder neck stenosis after application of existing endoscopic and reconstructive surgeries determines the relevance of studying new methods of treatment. In this respect, it is promising to study the possibilities of thulium laser.Objective. To study the efficacy and safety of a thulium laser for the treatment of benign bladder neck stenosis.Materials & methods. The study included 24 men with bladder neck stenosis of benign aetiology who underwent surgical treatment using the «Urolaz» (“IRE-Polus”, Fryasino, Russian Federation) thulium fibre laser. The treatment results were evaluated 3, 6, 12, 18 and 24 months (mo) after surgery, and then annually.Results. Postoperative follow-up time ranged from 3 to 50 mo (mean 21.1 ± 7.1 mo). With these follow-up periods, treatment was successful in 21 (87.5%) patients. The average period of recurrence was 2.8 ± 1.1 mo after surgery. A significant improvement in the following parameters was found in all periods of postoperative follow-up relative to preoperative data: maximum urination rate, average urination rate, residual urine volume, IPSS scores, and quality of life (p < 0.05). Early and late postoperative complications occurred in 8 (33.3%) and 2 (8.3%) patients, respectively, and all of them were mild and corresponded to the Clavien-Dindo I.Conclusions. The use of a thulium fibre laser for benign bladder neck stenosis makes it possible to achieve sufficiently high rates of efficiency and safety of treatment. This method can be considered among the main treatment options for this disease.

Keywords

• bladder neck stenosis
• thulium laser
• benign prostatic hyperplasia
• transurethral resection