Drug-coated balloon (DCB) urethral dilatation which offers an alternative to standard endoscopic treatments of male anterior urethral stricture disease (AUSD). Its ease of delivery has facilitated its use by urologists with various subspecialty interests. The objective of this study was to characterise real-world practice patterns of a DCB device.
An exploratory cross-sectional online survey was distributed to Optilume® users via national and international urological societies and device distributor mailing lists. Descriptive and inferential statistics were performed using SPSS software.
N = 102 urologists responded to the survey of whom n = 47 (46%) were reconstructive subspecialists. DCB dilatation was predominantly performed under general anaesthesia (n = 59, 58%). Significant variation was seen with catheter duration, perioperative antibiotic use and post-procedure contraception advice. Off-label use was common with respondents offering DCB for penile urethral strictures (65%), primary treatment (64%) and bladder neck stenoses (65%). Higher-volume users (≥ 10/year) were more likely to perform DCB under flexible cystoscopy (OR 5.14, 95% 1.57-16.79, p = 0.007), bladder neck stricture (OR 4.66, 95% CI 1.55-14.03, p = 0.006), and for recurrences (OR 6.92, 95% CI 2.22-21.6, p = 0.001). Limited practitioner experience, an evidence gap, and the importance of shared decision making were highlighted on thematic analysis.
This study provides an insight into the early experience a novel DCB among practicing urologists. Further research is required to optimize patient selection, procedural protocols and the understanding of long-term outcomes.
World journal of urology. 2026 Apr 07*** epublish ***
Diarmuid D Sugrue, John O'Connor, Łukasz Białek, Francesco Chierigo, Mikołaj Frankiewicz, François Xavier Madec, Behzad Abbasi, Leonidas Karapanos, Jakob Klemm, Mattia Lo Re, Juan Diego Tinajero, Jordán Scherñuk, Guglielmo Mantica, Paul Neuville, Maciej Oszczudłowski, Wesley Verla, Malte W Vetterlein, Niall F Davis, Felix Campos-Juanatey, Elaine J Redmond
Department of Urology, Cork University Hospital, Cork, Ireland. ., Department of Urology, Cork University Hospital, Cork, Ireland., Department of Urology, Centre for Postgraduate Medical Education, Warsaw, Poland., Department of Urology, Department of Health Science, University of Milan, ASST Santi Paolo e Carlo, Milan, Italy., Department of Urology, Medical University of Gdańsk, Gdansk, Poland., Department of Urology, Ambroise Paré-Hartmann Private Hospital Group, Paris, France., Department of Urology, University of California, San Francisco, CA, USA., Department of Urology, Klinikum Leverkusen, Leverkusen, Germany., Department of Urology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany., Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy., Chelsea Centre for Gender Surgery. Chelsea and Westminster Hospital NHS Trust, London, UK., Department of Urology, Hospital Italiano de Buenos Aires, Ciudad Autónoma de Buenos Aires, Argentina., Department of Surgical and Diagnostic Integrated Sciences (DISC), University of Genoa, Genoa, Italy., Department of Urology, Hospital Lyon Sud, Hospices Civils de Lyon, Lyon, France., Department of Urology, Ghent University Hospital, Ghent, Belgium., Department of Urology, Beaumont Hospital, Dublin, Ireland., School of Medicine, Unit of Andrology and Reconstructive Urology, Marqués de Valdecilla University Hospital, IDIVAL, Cantabria University, Santander, Spain.