Erbium: YAG Laser Incision of Urethral Strictures for Treatment of Urinary Incontinence After Prostate Cancer Surgery

摘要

Urethral and bladder neck strictures occur in 5-20 % of all prostate cancer surgeries, resulting in urinary incontinence. Conventional treatments for stricture have widely variable success rates with sub-optimal longterm results. The failure of these treatments is presumably due to mechanical and/or thermal damage to the urethral wall during the procedure. The purpose of this research project is to test a new laser, the Erbium:YAG laser, which is capable of precisely incising the urethral stricture with minimal peripheral damage to adjacent healthy tissue. We hypothesize that minimal side-effects caused during Erbium laser incision should translate into limited scarring and improved procedural success rates. Year 1 of this project was devoted to optimization of the laser and optical fiber delivery system for rapid and precise cutting of urethral tissue. We accomplished these tasks, and published our findings in the form of four manuscripts and two abstracts. Year 2 of this project was devoted to in vivo animal studies comparing the wound healing after Erbium and Holmium laser incision of the urethra and bladder neck. Further improvement of the optical fiber delivery system was also accomplished. We have published our findings in the form of five manuscripts and two abstracts.