Paclitaxel Drug-coated Balloon (Optilume) for Ureteral Stricture Management: Technical Description and Initial Clinical Experience.

The study aims to describe a standardized technique for ureteral dilation using a paclitaxel drug-coated balloon (Optilume) and to report early clinical outcomes in a preliminary single-center series. Patients with benign ureteral strictures treated at a single tertiary referral center were prospectively enrolled. All procedures were performed by a single experienced endourologist using a standardized protocol combining initial high-pressure mechanical dilation followed by drug-coated balloon (Optilume) application. The primary outcome was radiological resolution of hydronephrosis, reflecting restoration of ureteral patency. Secondary outcomes included technical success, perioperative outcomes, renal function changes, and the need for reintervention during follow-up. Between June and September 2025, six patients underwent ureteral dilation with a drug-coated balloon. Median age was 60.5 yr, and most strictures were postureteroscopic in origin (83%). Technical success was achieved in all cases without intraoperative complications. After a median follow-up of 6 mo (range, 5-7), four patients (67%) demonstrated complete resolution of hydronephrosis, while renal function was preserved or improved in all cases. One patient (17%) developed stricture recurrence requiring repeat dilation, whereas five patients (83%) remained free from further intervention. Overall, the procedure was associated with 100% technical success and 83% short-term freedom from reintervention. Ureteral dilation using a paclitaxel drug-coated balloon is a feasible and safe minimally invasive approach for the management of benign ureteral strictures. Early outcomes suggest favorable patency rates and preservation of renal function. Larger prospective studies with longer follow-up are required to confirm durability and define optimal indications.