Contact neodymium: YAG laser ablation of recurrent urethral strictures using a side-firing fiber

We evaluated the 2-year follow-up results of contact vaporization of recurrent urethral strictures using a side-firing Nd:YAG laser fiber. A total of 21 male patients with recurrent benign urethral strictures 5 to 20 mm in length were treated with Nd:YAG laser in the contact mode using a side-firing probe. An initial urethrotomy was made at the 12 o'clock position by retrograde vaporization of the scarred tissue through the total length of the stricture with the aid of a metal guidewire. Then all the scarred tissue was gradually vaporized circumferentially until an adequate channel had been created and healthy normal tissue was visible. The mean operation time was 35 minutes (range 20-55 minutes). No significant bleeding or serious complication was seen in the perioperative or postoperative period. Hospital stay and catheterization time were 48 hours or less in all cases. The success rates at 6, 12, and 24 months were 76%, 67%, and 52%, respectively. The morbidity of the laser treatment was minimal. The contact Nd:YAG laser is a safe treatment modality for recurrent urethral strictures. In view of the moderately durable successful results, it may be considered a last attempt at a minimally invasive treatment before making the decision for open urethroplasty.