[The usefulness of laser in the treatment of urethral stenosis].

INTRODUCTION

Optical urethrotomy was introduced by Sachse in 1973 and it has a registered long-term recurrence rate of 75-80%. This stimulated the search for new therapies with less recurrences. Several types of laser were tried: Nd:YAG, KTP, Argon, Ho:YAG, diode,... Since the end of the '70s various types of laser are being used for the treatment of ureteral stenosis.

OBJECTIVES

To describe the usefulness of the laser energy in the treatment of ureteral stenosis, mainly recurrent stenosis and to analyze the current experience with various types of laser (diode, nd:yag, holmium, argon,...)

METHODS

We performed the systematic review of the bibliography, based on a medline search, and a detailed analysis of the selected articles.

CONCLUSIONS

1) The use of laser in the treatment of urethral stenosis is on the a valid, effective, and safe alternative option to optical urethrotomy, at least in the mid term; nevertheless, it has not demonstrated to date being better than that. 2) The election of treatment is surgeon dependent and, and no single technique has demonstrated to be clearly better than the others. 3) Prospective long-term studies with larger numbers of patients and longer follow-up are necessary. 4) Laser technology is extensive and it is not available in all centers.