Outcomes of drug-coated balloon dilation in patients with radiation-related urethral stenosis.

IF 1.7 3区 医学 Q4 ANDROLOGY
Translational andrology and urology Pub Date : 2025-08-30 Epub Date: 2025-07-29 DOI:10.21037/tau-24-461
Joel Masopeh, Audra Garrigan, Kevin Heinsimer, Lucas Wiegand
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引用次数: 0

Abstract

Background: The Optilume® drug-coated balloon is a urethral dilation balloon with a paclitaxel coating that combines mechanical dilation for immediate symptomatic relief with local drug delivery to maintain urethral patency. The ROBUST III trial concludes that Optilume is safe and superior to standard direct vision internal urethrotomy/dilation for the treatment of recurrent anterior urethral strictures <3 cm in length. However, there have been limited studies to show efficacy in the treatment of urethral stricture in the setting of post-radiation patients. This study aimed to clarify the safety and early efficacy of Optilume balloon dilation for urethral strictures in post-radiation patients.

Methods: All patients undergoing Optilume balloon dilation with at least 3 months of follow-up were evaluated over 27 months in a retrospective multi-institutional setting. Thirty patients who received pelvic radiation and subsequently developed symptomatic urethral strictures were selected from a total of 246 patients identified with symptomatic urethral strictures. Success was defined as the absence of recurrence of original presenting symptoms, no need for intermittent self-dilation, and no requirement for surgical intervention within the follow-up period for their urethral stricture.

Results: Successful Optilume balloon dilations without recurrence of symptoms were achieved in 24/30 (80%) patients. Failures with recurrence of strictures occurred in 20% (6/30) of cases. At a median follow-up of 353 (range: 91-818) days, 80% (24/30) of radiated patients had successful Optilume balloon dilation. Our data showed that 83% (5/6) of patients who experienced recurrence did so after 12 months. Among radiated patients without baseline incontinence, new stress incontinence developed postoperatively in 20% (3/15), while one patient had improved stress incontinence.

Conclusions: Optilume balloon dilation is a safe mechanism of treatment for urethral stricture disease in radiated patients. Early follow-up data of the treatment of urethral strictures in radiated patients suggests similar efficacy. However, long-term follow-up data is needed.

药物包被球囊扩张治疗放射相关性尿道狭窄的疗效。
背景:Optilume®药物包被球囊是一种带有紫杉醇包被的尿道扩张球囊,它结合了机械扩张以立即缓解症状和局部给药以保持尿道通畅。鲁棒III试验得出结论,Optilume在治疗复发性前尿道狭窄方面是安全的,并且优于标准的直接视觉内尿道切开/扩张术。方法:所有接受Optilume球囊扩张术且随访至少3个月的患者在回顾性多机构环境中进行了27个月的评估。从246例有症状性尿道狭窄的患者中选择30例接受盆腔放疗后出现症状性尿道狭窄的患者。成功的定义是在随访期间没有复发的原始症状,不需要间歇性的自我扩张,不需要手术干预尿道狭窄。结果:24/30(80%)的患者均实现了Optilume球囊扩张成功且无症状复发。20%(6/30)的病例失败并狭窄复发。中位随访353天(范围91-818天),80%(24/30)放疗患者成功实现Optilume球囊扩张。我们的数据显示,83%(5/6)的复发患者在12个月后复发。在基线无尿失禁的放射患者中,20%(3/15)的患者术后出现新的应激性尿失禁,1例患者应激性尿失禁得到改善。结论:尿道球囊扩张术是治疗放射患者尿道狭窄疾病的一种安全机制。放射治疗尿道狭窄患者的早期随访数据显示相似的疗效。然而,需要长期随访数据。
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来源期刊
CiteScore
4.10
自引率
5.00%
发文量
80
期刊介绍: ranslational Andrology and Urology (Print ISSN 2223-4683; Online ISSN 2223-4691; Transl Androl Urol; TAU) is an open access, peer-reviewed, bi-monthly journal (quarterly published from Mar.2012 - Dec. 2014). The main focus of the journal is to describe new findings in the field of translational research of Andrology and Urology, provides current and practical information on basic research and clinical investigations of Andrology and Urology. Specific areas of interest include, but not limited to, molecular study, pathology, biology and technical advances related to andrology and urology. Topics cover range from evaluation, prevention, diagnosis, therapy, prognosis, rehabilitation and future challenges to urology and andrology. Contributions pertinent to urology and andrology are also included from related fields such as public health, basic sciences, education, sociology, and nursing.
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