Erbium vs. Holmium laser incision of the urethra and bladder neck

The objective of this study is to evaluate in an animal model differences in wound healing and scar formation in healthy urethra and bladder neck incised with the Erbium:YAG and Holmium:YAG lasers. In each of 18 domestic pigs, three 1-cm-long incisions were made, two at the bladder neck and one in the mid-urethra using either the Er:YAG laser (9 pigs) or the Ho:YAG laser (9 pigs). In each laser group, three animals were sacrificed on postoperative (POD) days 0, 6, and 14. Width of collateral damage, as evidenced by coagulation necrosis and granulation tissue at the wound base, and incision depth were evaluated during tissue analysis. Collateral damage with the Er:YAG laser at POD 0, 6 and 14 was 20 ± 5 μm, 900 ± 100 μm, and 430 ± 100 μm, respectively. Damage with the Ho:YAG laser was 660 ± 110 μm, 2280 ± 700 μm, and 1580 ± 250 μm, respectively. The granulation tissue was significantly less (p < 0.05) at all time points with the Er:YAG laser. Similarly, incision depths for the two laser groups at days 6 (1100 ± 200 μm vs 1500 ± 300 μm) and 14 (670 ± 140 μm vs 1240 ± 140 μm) were also significantly less (p < 0.05) for the Er:YAG laser group, indicating faster healing of the wound created. In this in vivo animal study, incisions in the urethra and bladder neck made with the Er:YAG laser healed faster and with less scar formation than incisions made with the Ho:YAG laser.