Efficacy of Drug-coated Balloon Dilation Versus Endoscopic Standard Treatment in Posterior Urethral Stenosis: A Real-world Comparative Study

Berg, Elena Katharina ; Mehmedovic, Selma; Askari, Darjusch; Hermans, Julian; Hoffmann, Marina Alexandra; Keller, Patrick; Marcon, Julian; Weinhold, Philipp ; Stief, Christian Georg; Eismann, Lennert und Bischoff, Robert (2025): Efficacy of Drug-coated Balloon Dilation Versus Endoscopic Standard Treatment in Posterior Urethral Stenosis: A Real-world Comparative Study. In: Urology [Forthcoming]

Abstract

Objective

To evaluate recurrence rates and functional outcomes after drug-coated balloon (DCB) dilation (Optilume) compared to standard endoscopic treatment in patients with posterior urethral stenosis.

Methods

In this retrospective cohort study, we evaluated postoperative outcomes of patients who underwent either DCB dilation or standard endoscopic treatment for posterior urethral stenosis (vesicourethral anastomotic stenosis and bladder neck contracture). Recurrence-free survival (RFS) was recorded. Multivariate analysis was conducted to identify factors leading to improved RFS. Additionally, functional outcomes were analyzed in the DCB group.

Results

A total of 141 patients were included in the study. Of these, 65 underwent DCB dilation, while 76 received standard treatment. Cohorts were matched in age, initial treatment, and history of radiotherapy (each P>.05). Patients treated with DCB demonstrated significantly improved RFS compared to standard treatment group (P=.013). Multivariate analysis confirmed treatment modality as a significant predictor of RFS (hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.19-0.87, P=.021). Functional analysis in the DCB group showed a reduction in post-void residual volume (55 mL vs 0 mL, P<.001) and an increase in maximum urinary flow rate (Qmax: 9mL/s vs 22mL/s, P=.001).

Conclusion

In conclusion, this study demonstrates that Optilume DCB dilation may be an effective treatment option for posterior urethral stenosis. These findings support the continued study of DCB as a promising, minimally invasive, and safe alternative for managing posterior urethral stenosis. Long-term studies including standardized follow-up intervals and parameters are warranted to validate these results and assess durability beyond the follow-up period.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin > Klinikum der LMU München > Urologische Klinik und Poliklinik
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 00904295
• Sprache: Englisch