Optilume Drug-Coated Balloon Dilation for Male Sphincteric (Membranous) Urethral Strictures: 53 Consecutive Cases

Area of Science:

• Urology
• Minimally Invasive Surgery
• Medical Devices

Background:

• Membranous urethral strictures involving the sphincter present surgical challenges, including risks of incontinence and erectile dysfunction.
• Optilume drug-coated balloon dilation (DCBD) is a minimally invasive option for bulbar strictures, but its use in sphincteric strictures is debated.

Purpose of the Study:

• To evaluate the safety, efficacy, and impact on continence of DCBD for membranous urethral strictures involving the male sphincter.
• To assess the outcomes of DCBD in patients with strictures extending into the sphincteric urethra.

Main Methods:

• Retrospective analysis of 53 patients with sphincteric urethral strictures treated with Optilume DCBD.
• Assessment of anatomical success, freedom from re-intervention, and continence status post-procedure.
• Exclusion of patients with neurological conditions or urinary infections.

Main Results:

• 66.6% and 65.6% of patients remained free from recurrence and re-intervention with satisfactory voiding.
• No new-onset urinary incontinence was observed in the study cohort.
• Two patients with pre-existing incontinence remained incontinent; no worsening of continence occurred.

Conclusions:

• Optilume DCBD is a safe and effective treatment for membranous urethral strictures involving the sphincter.
• DCBD does not induce de novo incontinence in patients with sphincteric urethral strictures.
• This minimally invasive approach offers a valuable alternative for carefully selected patients, though not a substitute for reconstructive surgery.