Outcomes of laser endoureterotomy using diode and holmium lasers in benign ureteral stricture management: a retrospective cohort study

Abstract Background Our experience of endoureterotomy with diode (150 & 200 Watt) and holmium lasers. Methods A retrospective study involving 60 patients (39 male and 21 female) treated for benign ureteric strictures used either diode laser (29 patients) or holmium laser (31 patients) was conducted. The strictures were located proximally (26), mid-ureter (9), and distally (25) and were addressed retrogradely using an 8Fr or 6Fr semi-rigid ureteroscope. Laser energy application ranged from 5 to 15W for diode and 5 to 15W for holmium laser, often combined with balloon dilatation. An indwelling 8-6Fr DJ stent was placed for 1 to 1.5 months. Success was characterized as symptom improvement and lack of hydronephrosis on interval imaging at 3–6 months. We considered p < 0.05 to be significant. Results Patients were monitored for a minimum of 18 months (18 ± 10.4). The patients’ mean age was 32.96 ± 11.68 vs. 33.38 ± 11.83, and mean stricture length was 01 ± 0.41 vs. 0.8 ± 0.50 in diode vs. holmium laser groups, respectively. The causes of strictures included idiopathic (19), passage of stone (11), and previous pyeloplasty (06). Recurrent strictures occurred in 11 out of 60 patients (18.33%), with 4 vs. 7 from the diode and holmium groups. The overall success rate was 49/60 (81.66%), with individual success rates of 25/29(86.20%) for diode laser and 24/31(77.41%) for holmium laser, p < 0.05. Conclusions The 980 nm diode and holmium lasers are effective treatments for ureteral strictures, with the diode laser showing a marginally greater success rate in comparison to the holmium laser.