{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,29]],"date-time":"2026-05-29T15:44:38Z","timestamp":1780069478552,"version":"3.54.0"},"reference-count":13,"publisher":"S. Karger AG","issue":"2","license":[{"start":{"date-parts":[[2006,1,1]],"date-time":"2006-01-01T00:00:00Z","timestamp":1136073600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"},{"start":{"date-parts":[[2006,1,1]],"date-time":"2006-01-01T00:00:00Z","timestamp":1136073600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.karger.com\/Services\/SiteLicenses"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Urol Int"],"published-print":{"date-parts":[[2006]]},"abstract":"<i>Introduction:<\/i> The urethral syndrome is characterized by irritative disturbances, the urgency-frequency syndrome and\/or pain associated with negative urine cultures. Areas of metaplasic tissue in the trigonal-bladder neck region (trigonitis) are sometimes present. We performed a comparative randomized study to assess the efficacy of side- or end-firing neodymium (Nd):YAG laser surgery in destroying metaplasia and relieving symptoms. <i>Materials and Methods:<\/i> Between January 1997 and December 2003, 62 consecutive women with the urethral syndrome and squamous metaplasia of the bladder neck-trigone, who were refractory to drugs, were randomly assigned to treatment with end-firing (group A) or side-firing (group B) Nd:YAG laser. Three, 6 and 12 months after surgery all patients underwent a clinical urological examination and cystoscopy. Surgery was considered successful when patients reported they were satisfied with the outcome or stated on the UDI-6 questionnaire that symptoms were reduced by at least 75%. <i>Results: <\/i><i>Group A end-firing laser:<\/i> patients rapidly improved (2\u20133 weeks) but symptoms worsened within 3 months. At 6\u201312 months, symptoms had improved in 19% of the 31 patients and remained unchanged or worsened in 81%. <i>Group B side-firing laser:<\/i> irritative disturbances worsened in the 7\u201310 days after therapy but markedly improved within 2\u20133 months. Symptoms significantly improved in 68% of the 28 patients and remained unchanged or worsened in 32%. Results were significantly better after side-firing laser (p < 0.001) and a trend towards improvements emerged as the joule levels rose. At 3 months, cystoscopy and biopsy showed squamous metaplasia was no longer present in patients whose symptoms had improved. Whitish areas were still present in the bladder neck-trigone in patients whose symptoms had remained unchanged or worsened. These patients were retreated. <i>Conclusions:<\/i> In the treatment of the urethral syndrome the few reports on attempts to restore a normal urothelium by means of diathermocoagulation and cryotherapy have been encouraging. Side-firing laser, which produces necrotic coagulation followed by reconstitution of normal functional epithelium, was significantly more successful than end-firing and was associated with a 78% success rate. These results are encouraging in patients who are usually refractory to medical therapy.<\/jats:p>","DOI":"10.1159\/000090876","type":"journal-article","created":{"date-parts":[[2006,2,22]],"date-time":"2006-02-22T11:46:38Z","timestamp":1140608798000},"page":"134-138","source":"Crossref","is-referenced-by-count":24,"title":["Treatment of Urethral Syndrome: A Prospective Randomized Study with Nd:YAG Laser"],"prefix":"10.1159","volume":"76","author":[{"given":"Elisabetta","family":"Costantini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alessandro","family":"Zucchi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Del Zingaro","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luigi","family":"Mearini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2006,2,24]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1056%2FNEJM198008213030801"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1464-410X.1981.tb06102.x"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1016%2FS0090-4295%2801%2901141-4"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1016%2FS0090-4295%2899%2900141-7"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1464-410X.1977.tb04166.x"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016%2FS0302-2838%2802%2900358-5"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.1016%2FS0022-5347%2805%2966093-4"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1002%2Fnau.1930140206"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1111%2Fj.1464-410X.1983.tb06553.x"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1016%2FS0022-5347%2805%2964649-6"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1126%2Fscience.1084550"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1002%2Flsm.1900080406"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1016%2F0022-4804%2887%2990117-X"}],"container-title":["Urologia Internationalis"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/90876","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/90876","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T02:48:45Z","timestamp":1745462925000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000090876"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2006,2,1]]}},"URL":"https:\/\/doi.org\/10.1159\/000090876","archive":["Portico"],"relation":{},"ISSN":["0042-1138","1423-0399"],"issn-type":[{"value":"0042-1138","type":"print"},{"value":"1423-0399","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006]]}}}