Abstract:

Objective To evaluate the clinical effect and feasibility of high power holmium laser wedge neck resection in patients with bladder neck contracture.

Methods 60 patients were randomly divided into two groups：30 patients in each group；the control group received transurethral resection of bladder neck；the experimental group received wedge resection of bladder neck with medical staff 80～100w and 550um holmium laser surgery system，and the clinical effect was observed.

Results Inthe control group，the operative time，catheter retention time，intraoperative blood loss and hospitalization time were（100.95±18.74）min，（7.86±1.95）d，（86.9±10.69）ml，（8.95±1.95）d，The experimental groups were（26.78±4.28）min，（2.96±0.54）d，（10.45±1.82）ml，（3.64±0.79）d，the comparison between the two was statistically significant（P<0.05）.Before treatment，there was no statistically significant difference in quality of life （QOL），international prostate symptom score （IPSS），postvoid residual volume （PVR）and  maxium urinary flow rate （Qmax）between the two groups（P>0.05）.7d After treatment，QOL score，IPSS score，PVR and Qmax in the experimental group and control group were（2.74±0.52）score，（10.68±1.94）score，（65.49±12.36）ml，（14.89±2.46）ml/s；（4.86±0.86）score，（15.95±2.89）score，（100.69±21.34）ml，（10.37±2.14）ml/s，all of which were significantly better than those before treatment（P<0.05），and the improvement degree of the patients in the experimental group was greater.Six months after treatment，the QOL，IPSS，PVR and Qmax  were（1.74±0.25）score，（6.84±1.49）score，（20.69±3.52）ml and（21.48±4.68）ml/s，in the experimental group，the control group were（2.96±0.48）score，（12.74±2.35）score，（43.74±6.84）ml and（15.43±3.92）ml/s，the experimental group was better than the control group（P<0.05）.The complication rate of the experimental group（3.33%）was lower than that of the control group（13.33%）（P<0.05）.

Conclusion High power holmium laser is safe and effective for neck wedge resection in patients with bladder neck contracture，with less bleeding，short operation time and simple operation，which is an ideal minimally invasive surgical method.

Key words: high power holmium laser, bladder neck contracture, neck, wedge incision, minimally invasive surgery