Direct Vision Internal Urethrotomy with Application of Holmium: YAG Laser

Introduction: Male urethral stricture is a complicated urologic disease that could be successfully treated using internal urethrotomy. Laser internal urethrotomy has been used in many cases with favorable outcome in many studies. Holmium: YAG laser with its incisional properties on tissue is one of the laser types applied for internal urethrotomy. Methods: We present a 19 year-old male with history of aortic valve stenosis and metallic aortic valvoplasty on prescription of oral anti-coagulant therapy (Warfarin) who was a candidate for internal urethrotomy due to bulbar urethral stricture. Holmium laser core-through urethrotomy was performed for him. Results: Internal urethrotomy was done using the ablative 50-watt Holmium: YAG laser 2140 nm (manufactured by the Atomic Energy Organization of Iran [AEOI]). No complication was observed intra- and post-operatively. After 6 months of followup no evidence of urethral stricture was observed. Conclusion: According to our study, Ho-YAG laser core through urethrotomy is a safe and effective procedure. It is a less invasive alternative to more complex urethroplasty procedures for patients with post-traumatic urethral stricture with high risk of urethral bleeding due to anti-coagulant therapy.