Abstract:Objective: To investigate the therapeutic effect of transurethral thulium laser treatment for ureterocele in adults. Methods: Twenty-three adults with ureterocele were given transurethral thulium laser treatment from January 2008 to October 2016. Thulium laser was used with electric cutting power of 50 W and fiber diameter of 550 μm. The ureterocele was found under the cystoscopy and the size was determined. For the cysts ≤2 cm in diameter, they were removed from the roots by thulium laser; for the larger ureter cysts with 2-5 cm in diameter, the upper part of about 2/3 cyst wall was retained during the cystectomy, so that the remaining cyst wall could form a tongue-shaped valve to prevent vesicoureteral reflux. At the end of the operation, F5 double "J" tubes were indwelled for drainage. Results: Twenty-three cases were successfully treated. Operative time was 20-37 min (mean 31 min), and blood transfusion was not given. Postoperative hospital stay was 3-6 days (mean 4 days). The double J tubes were removed 1 month after discharge. Twenty-three patients were followed up for 6-24 months (mean 12 months). The postoperative hematuria, dysuria, abdominal pain and other clinical symptoms disappeared in 23 patients. No recurrence was found by ultrasound. In 23 cases of hydronephrosis by intravenouspyelography, hydronephrosis disappeared in 21 cases, and relieved in 2 cases. No vesicoureteral reflux and ureteral stricture occurred. Conclusions: Transurethral thulium laser treatment for ureterocele <5 cm in diameter possesses the advantages of precise cutting, less damage, less complications, and outstanding curative effects.
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