Comparative study of holmium laser versus cold-knife optical internal urethrotomy in urethral stricture

Objective: One of the most difficult urological ailments is to cure the urethral stricture adequately. There are various methods employed for the treatment of urethral stricture. This analysis was conducted to compare the efficacy and safety of holmium laser versus cold-knife optical urethrotomy for operative time, complications, and recurrence. Methods: The study design is a comparative study. The study participants were enrolled after procuring voluntary informed consent. Fifty-six patients were included in the study from the Urology department Super Speciality Hospital, GMC, Jammu from 1 November 2017 to 31 October 2018 and were divided into Group 1 (holmium group) and Group 2 (cold-knife group). Patients were catheterised with 14 Fr Foley's catheter after the procedure and the catheter was removed on the third postoperative day. Patients were followed for 6 months. At each follow-up physical examination and uroflowmetry were performed. On the 90th post-operative day, a retrograde urethrogram was performed. Results: Both the cold knife and holmium laser have been safe and effective in providing immediate relief to patients with single and short-segment (< 1 cm long) urethral strictures. The cold knife offers a significant advance over the holmium laser in terms of the operative time, which was shorter in the cold-knife group. The success rates for laser and cold knife were similar. Conclusion: The success rates for laser and cold knife were very similar, with the groups having a similar trend in success rates at different follow-up time points. The present findings may benefit from long-term follow-up analysis. Level of evidence: 4