Urology · 2025
Early Real-World Experience With Optilume Drug-coated Balloon for Anterior Urethral Strictures and Posterior Urethral Stenoses.
СтатьяНазвание и аннотация: Перевод в очереди
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Patel Hiren V, Erickson Bradley A, Abbasi Behzad, Alsikafi Nejd F, Broghammer Joshua A, Pandit Kshitij, Buckley Jill C, Elliott Sean P, Daryabari Seyedeh Sima, Myers Jeremy B, Smith Thomas G, Lindekugel Grady, Voelzke Bryan B, Vanni Alex J, Zhao Lee C, Breyer Benjamin N
Аннотация
OBJECTIVE: To determine the early experience with paclitaxel-drug coated balloon (DCB) for both anterior urethral stricture disease (aUSD) and posterior urethral stenoses (PUS).
METHODS: A retrospective review of patients undergoing Optilume DCB in the Trauma and Urologic Reconstructive Network of Surgeons (TURNS) database was performed. Both functional (improved subjective voiding without a secondary procedure) and anatomic (open lumen on cystoscopy) success rates were determined. Kaplan Meier estimates were used to determine the risk of failure by LSE classification and LSE Stage.
RESULTS: A total of 319 patients were treated with the DCB, of which 260 were for aUSD and 59 were for PUS. Median age was 64 years (Interquartile range [IQR] 48-73). Recurrence was noted in 119 patients (37.3%) at a median follow-up of 5.7 months (IQR 3-12). For aUSD, the 1-year functional recurrence-free survival was 78.4% (95% CI 71.8-85.4) and anatomical recurrence-free survival was 66.4% (95% CI 59.5-74.2). For PUS, the 1-year functional recurrence-free survival was 75.8% (95% CI 61.4-93.7) and anatomical recurrence-free survival was 59.4% (95% CI 44.1-80). Recurrences of any kind were significantly more likely in patients with strictures after hypospadias repair (HR 5.21, 95% CI 1.06-25.6, P = .042), and use of 24 Fr, 3 cm DCB (HR 3.64, 95% 1.10-12.09, P = .035). These were also significant predictors of anatomical recurrences.
CONCLUSION: Multi-institutional utilization of the DCB for aUSD and PUS demonstrates a low effectiveness among high-risk strictures. Recurrence after DCB varies based on stricture characteristics and subtype, which are important for preoperative counseling and postoperative surveillance.
METHODS: A retrospective review of patients undergoing Optilume DCB in the Trauma and Urologic Reconstructive Network of Surgeons (TURNS) database was performed. Both functional (improved subjective voiding without a secondary procedure) and anatomic (open lumen on cystoscopy) success rates were determined. Kaplan Meier estimates were used to determine the risk of failure by LSE classification and LSE Stage.
RESULTS: A total of 319 patients were treated with the DCB, of which 260 were for aUSD and 59 were for PUS. Median age was 64 years (Interquartile range [IQR] 48-73). Recurrence was noted in 119 patients (37.3%) at a median follow-up of 5.7 months (IQR 3-12). For aUSD, the 1-year functional recurrence-free survival was 78.4% (95% CI 71.8-85.4) and anatomical recurrence-free survival was 66.4% (95% CI 59.5-74.2). For PUS, the 1-year functional recurrence-free survival was 75.8% (95% CI 61.4-93.7) and anatomical recurrence-free survival was 59.4% (95% CI 44.1-80). Recurrences of any kind were significantly more likely in patients with strictures after hypospadias repair (HR 5.21, 95% CI 1.06-25.6, P = .042), and use of 24 Fr, 3 cm DCB (HR 3.64, 95% 1.10-12.09, P = .035). These were also significant predictors of anatomical recurrences.
CONCLUSION: Multi-institutional utilization of the DCB for aUSD and PUS demonstrates a low effectiveness among high-risk strictures. Recurrence after DCB varies based on stricture characteristics and subtype, which are important for preoperative counseling and postoperative surveillance.