Objective: Thulium laser (ThL) has become popular in urology, because of its powerful action on tissue, achieving optimal ablation and hemostasis. Aim of our article was to evaluate efficacy of ThL in infants affected by posterior urethral valve (PUV) ablation. Patients and Methods: Clinical charts of 25 infants (age ≤12 months) who underwent PUV ablation were retrospectively reviewed. According to our protocol, all patients performed voiding cystourethrography and cystoscopy 6 to 8 months after initial treatment. Several factors, including age and weight at surgery, operative time, postoperative bleeding, catheterization period, postoperative urinary retention, retreatment for valve remnants, and stricture at follow-up, were evaluated. Preoperative, intraoperative, and postoperative data were analyzed. Results: Mean age at primary surgery was 4.5 months (5 days-10.5 months) and mean weight at primary surgery was 5.7 kg (2.5-10.3 kg). Mean operative time was 29.5 minutes (range 15-50 minutes). None of the patients experienced intraoperative and postoperative bleeding. In all cases, postoperative catheterization period was 1 day. Residual valves were found in 6 of 25 (24%) patients. No cases of urethral stricture were registered during follow-up (48.4 months, range: 11-95). Analyzing literature data using other techniques, complication rate of ThL PUV ablation seems lower than standard treatments (electrofulguration, cold knife) and comparable with those reported with other laser techniques. Conclusion: PUV ablation with ThL has proven to be feasible and safe in infants. Further studies are needed to define the real effectiveness of this laser technology in PUV ablation. Miniaturized instruments and ThL technology make early PUV treatment feasible also in low body weight newborns.

中文翻译：

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铥激光治疗婴儿后尿道瓣膜。

目的：铥激光（ThL）因其对组织的强大作用，实现最佳消融和止血而在泌尿外科中广受欢迎。我们文章的目的是评估 ThL 对受后尿道瓣膜 (PUV) 消融术影响的婴儿的疗效。患者和方法：回顾性分析 25 例接受 PUV 消融的婴儿（年龄≤12 个月）的临床图表。根据我们的方案，所有患者在初次治疗后 6 至 8 个月进行排尿性膀胱尿道造影和膀胱镜检查。评估了几个因素，包括手术时的年龄和体重、手术时间、术后出血、导尿时间、术后尿潴留、瓣膜残留的再治疗以及随访时的狭窄。分析术前、术中和术后数据。结果：初次手术时的平均年龄为 4.5 个月（5 天至 10.5 个月），初次手术时的平均体重为 5.7 公斤（2.5-10.3 公斤）。平均手术时间为 29.5 分钟（范围 15-50 分钟）。没有患者出现术中和术后出血。所有病例术后导尿时间均为 1 天。25 名患者中有 6 名 (24%) 发现了残余瓣膜。随访期间（48.4 个月，范围：11-95）未发现尿道狭窄病例。使用其他技术分析文献数据，ThL PUV 消融的并发症发生率似乎低于标准治疗（电灼、冷刀），并且与其他激光技术报道的并发症率相当。结论：事实证明，使用 ThL 进行 PUV 消融对于婴儿来说是可行且安全的。需要进一步研究来确定这种激光技术在 PUV 消融中的真正有效性。小型化仪器和 ThL 技术使得早期 PUV 治疗在低体重新生儿中也可行。