Use of Laser in the Treatment of Urethral Hemangioma

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The urethral localization of anhemangiomas is very rare. Responsible for urethrorrhagia and/or hemospermia, the diagnosis is easily made by endoscopy. On the other hand, the treatment remains difficult because of the localization urethral. Nous report the case of a man of 28 years treated with Laser Nd YAG.A man of 28, with no particular history, had urethrorrhages associated with initial hematuria since the age of 20 years. A first endoscopic assessment, found a single hemangiomatous lesion located in the navicular fossa that was treated by electrocoagulation. Six months later, with a greater bleeding recurrence, a new urethrocystoscopy showed the appearance of a new hemangiomatous localization extended to the ventral side of the maxillary anterior urethra in the bulbar urethra and extending to on the meatus.

Arteriography was performed in search of a lesion that could be treated by embolization. This one did not find an arterial anomaly, but only a vascular puddle corresponding to the urethra at the venous time. Two years after, a new abundant urethrorrhagia, motivated an attempt of endoscopic treatment by electrocoagulation at the level of the most voluminous lesion located just under the striated sphincter. Due to the risk of secondary stenosis, coagulation was deliberately incomplete and bleeding recurrences were early.

The patient then presented daily urethrorrhages of low abundance without any repercussion or hemodynamic, nor anemia, but with a psychological and professional repercussion 3 months later, Laser Nd YAG coagulation was performed. The procedure was performed under general anesthesia, using an SLT Side Firing fiber equipped with the 40-watt lateral firing tip, positioned next to a cystoscope (Storz).