Abstract
Objectives
To examine the possibility of antegrade incisions at varying stricture lengths. We
have developed a new method of using a ureteroscope and holmium:yttrium-aluminum-garnet
(YAG) laser to make an antegrade incision without using a guidewire. Endoscopic internal
urethrotomy involves the use of a guidewire or ureteral catheter that is passed through
the stricture as an indicator for retrograde incision.
Methods
An antegrade incision was performed in 31 procedures for 28 patients with urethral
strictures. We used a semirigid ureteroscope with an outer diameter of 6F at the tip.
The ureteroscope was inserted into the urethra and passed through the stricture into
the bladder under direct vision. The ureteroscope was pulled distally while an incision
was made using the holmium:YAG laser at the 10-o’clock and 2-o’clock positions to
a diameter of 17F. The endoscope was then replaced by a 17F panendoscope and an antegrade
incision was similarly made up to 21F to 22F.
Results
An antegrade incision without the use of a guidewire was possible in all cases. Of
the 31 incisions, restenosis appeared in 11 (35%). Of the 11 cases, re-incision was
performed in 4 cases, and urethral sounding was conducted in the other 7 cases. Of
the 4 re-incision cases, restenosis recurred in only 1 case. Of the 31 incisions,
23 (74%) were eventually successful.
Conclusions
Antegrade incision using the narrow-diameter ureteroscope and holmium:YAG laser is
a safe and easy method. This method is especially effective in cases of long strictures.
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Article info
Publication history
Accepted:
August 5,
2002
Received:
April 8,
2002
Identification
Copyright
© 2002 Elsevier Science Inc. Published by Elsevier Inc. All rights reserved.
