Treatment of Refractory Vesicourethral Anastomosis Pain Following Radical Prostatectomy Using a Combination of Non-ablative Erbium:YAG and Neodymium:YAG Laser Therapy: A Case Report

This case report describes the successful treatment of refractory vesicourethral anastomosis (VUA) pain in an 82-year-old man following radical prostatectomy using a combination of non-ablative erbium:YAG and neodymium:YAG laser therapy with Fotona SP Dynamis. Despite various conventional treatments, the patient's pain persisted, which significantly impaired his quality of life. The rationale for using laser therapy is based on its potential to promote tissue healing and nerve regeneration and reduce inflammation at the anastomosis site. The patient underwent monthly laser irradiation sessions, with the erbium:YAG laser targeting the area around the urethral anastomosis site via the anus and the neodymium:YAG laser irradiating the base of the penis and scrotum. Urethral pain gradually decreased from a visual analog scale score of 10 to 0 over the course of treatment. This highlights the importance of considering alternative approaches when conventional methods fail to provide relief. The targeted, minimally invasive nature of laser therapy may offer a safer and more effective alternative to systemic medications for managing chronic post-surgical pain. Although further research is needed to establish the generalizability and long-term effectiveness of this approach, this case provides a promising foundation for future investigations of the role of laser therapy in managing refractory VUA pain following radical prostatectomy.