Efficacy of the Optilume Drug-Coated Balloon for Treatment of Posterior Urethral Strictures and Bladder Neck Contractures

Document Type

Conference Proceeding

Publication Date

5-2025

Publication Title

Journal of Urology

Abstract

INTRODUCTION AND OBJECTIVE: The treatment of posterior urethral strictures and bladder neck contractures can be challenging, and there is no clear standard endoscopic treatment. The Optilume drug-coated balloon has demonstrated benefit for treatment of both anterior urethral strictures and benign prostatic hyperplasia. We sought to evaluate its efficacy and safety profile for treatment of patients with posterior urethral strictures and bladder neck contractures. METHODS: We retrospectively analyzed patients who underwent endoscopic treatment with concurrent Optilume balloon dilation for posterior urethral strictures and bladder neck contractures between September 2022 and October 2023 at a single institution. Primary outcomes were rate of surgical reintervention and stricture resolution or improvement on post-operative office cystoscopy. Demographic and clinical data were analyzed using Fischer's exact test for categorical variables and t-test for continuous variables. RESULTS: Fifty-three men, with a median follow-up time of 15.9 months, were enrolled in the study. Of these, 16 (30%) had a history of prostatectomy, 35 (66%) had previously received pelvic radiation (brachytherapy or external beam), 10 (19%) had a history of both prostatectomy and pelvic radiation, and 10 (19%) had a prior TURP. Additionally, 37 (70%) patients had a history of prior endoscopic treatment, with a mean number of 2.4 treatments. The mean stricture length was 1.5 cm with a mean diameter of 8.5 Fr. Fifteen patients had a bladder neck contracture, while 38 had strictures involving the membranous or prostatic urethra. In total, 12/ 53 (22.6%) patients required surgical reintervention with time to reintervention ranging from 1.3 months to 15.1 months, with a median of 7.0 months. Surgical reintervention rate was significantly higher in patients with a history of pelvic radiation (11/12 patients, p=0.04). Thirty-three patients had post-operative cystoscopy completed with a median time after treatment of 3.4 months. Of these, 23 (70%) had demonstrated resolution or improvement. 11/53 patients had a documented adverse event, with the most common being gross hematuria (6/11), followed by urinary retention (4/11) and UTI (3/11). None of these patients required operative intervention for their complication. CONCLUSIONS: The Optilume drug-coated balloon is a viable option for the treatment of posterior urethral strictures and bladder neck contractures, although less successful in patients with a history of pelvic radiation. Further prospective, randomized trials are needed to better evaluate its efficacy in this patient population.

Volume

213

Issue

5S

First Page

e84

Last Page

e84

Comments

American Urological Association Annual Meeting, April 26-29, 2025, Las Vegas, NV

DOI

10.1097/01.JU.0001109736.77411.5f.12

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