Holmium Laser Core Through Urethrotomy

The surgical technique of “Urethrotomy” creates a widening of the urethra using a special instrument. The operation is performed endoscopically through the external urinary meatus, progressing up to the area that narrows, without invasive surgery.

There are two basic types of Urethrotomy:
  1. Internal urethrotomy by cold knife (Sachse’s technique). In this procedure, the narrow part of the
  2. urethra is incised, cutting the stricture at 12 o’clock, with a cold knife thus without cauterizing or using any other form of energy. The internal urethrotomy by cold knife is mainly used in patients with bulbar urethral strictures.
  3. Holmium laser urethrotomy. In this procedure, the narrow part of the urethra is incised, cutting the stricture at 12 o’clock, using a holmium laser fiber. The Holmium laser urethrotomy is mainly used in patients with posterior urethral strictures, or in patients with bladder neck contracture after prostatic surgery.

With these procedures, an endoscopic approach is used to open the urethra, in an outpatient service, day surgery or with a two-day hospital stay.

Urethrotomy is generally suggested in the following cases:
  1. patients with bladder neck contracture after prostatic surgery.
  2. patients with simple and short bulbar urethral strictures who had no previous treatment.
  3. patients who refuse the standard surgical approach or who prefer to delayed surgery.
  4. elderly patients with urethral strictures associated with poor general health conditions where lengthy anaesthesia to perform complex urethral repair is not recommended.