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 follow- up 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.