Holmium: YAG Versus Cold Knife Internal Urethrotomy in Management of Short Urethral Strictures
Holmium: YAG Versus Cold Knife Internal Urethrotomy in Management of Short Urethral Strictures
Urethral stricture disease is defined as narrowing of the urethral lumen because of fibrosis,
 which occurs in urethral mucosa and surrounding tissues. The etiology could be congenital,
 iatrogenic, infectious, or idiopathic.

 Several techniques are currently available for minimally invasive treatment of urethral
 strictures, including cold-knife incision, electrocautery, and various types of laser
 incisions. An incision with the cold knife does not cause any thermal effect on surrounding
 tissues but should create a mechanical injury that may lead to recurrence in long term. An
 incision with the electrocautery should cause a significant thermal effect on healthy
 surrounding tissues resulting in recurrent strictures during follow-up. Laser treatment
 modalities have gained popularity in the last two decades.

 the aim of this trial is to evaluate the safety and efficacy of endo-urethrotomy with Holmium
 laser and cold knife endo-urethrotomy
Urethral stricture disease (USD) is the narrowing of the urethra from scar tissue, related to
 genitourinary tract infections, inflammatory skin conditions, traumatic urethral injury,
 pelvic radiation, and urinary tract instrumentation. It has an estimated prevalence rate of
 0.6%.1-3 USD is a common and challenging problem for urologists. Multiple treatment
 modalities are available for the management of urethral strictures depending on the site and
 length of stricture, this includes simple urethral dilatation, urethral stenting, endoscopic
 visual internal urethrotomy (VIU), or open reconstruction.

 Since 1974, Sachse's internal urethrotomy has been considered the treatment of choice for USD
 which is fast and simple to carry out and is associated with a short recovery time. The
 success rates are 33%-60%.

 Bulow et al in 1979 introduced the laser for internal urethrotomy. The obvious dominance of
 Ho: YAG are clear vision, less bleeding, precise incision and ablation of scar tissue, and
 short hospital admission, however, most literature assessing the adequacy of the laser in
 contrast to cold-knife urethrotomy show no difference in final results.

 The aim of this trial is to assess the efficacy, safety, complications, and results of
 Holmium laser urethrotomy and cold knife internal urethrotomy for urethral stricture.
Inclusion Criteria:

 -  men with urethral stricture above the age of eighteen were included in our trial. the
 length of the urethral stricture was less than 1.5 cm.

 Exclusion Criteria:

 -  patient with complete urethral stricture with a suprapubic catheter in place.

 -  patients whom internal urethrotomy is not applicable like multiple urethral strictures
 or balanitis xerotica obliterans.