Treatment of anterior urethral stricture with paclitaxel-coated balloon dilator in children: preliminary report
DOI:
https://doi.org/10.48193/1h3wgr24Keywords:
Paclitaxel-coated balloon dilator, drug coated-balloon treatment, recurrent urethral stricture, anterior urethral strictureAbstract
Case description: Three pediatric patients with urethral stenosis due to multiple etiologies underwent mechanical Paclitaxel coated balloon dilation (Ranger TM). All of them underwent fluoroscopic follow-up at 3 months and no recurrence was observed.
Relevance: The worldwide incidence of urethral stenosis in males is 0.2-0.6 %. Currently, urethroplasty is the best therapeutic option. Paclitaxel is an antiproliferative drug initially used as a chemotherapeutic agent and currently used for resolution of coronary obstruction due to the inhibition of fibroblast growth. We advocate for its use along with mechanical ballon dilation for the treatment of urethral stenosis.
Clinical implications: Urethral Paclitaxel balloon dilation has shown better anatomic and functional results in anterior urethral stenosis compared with endoscopic treatment, specially in recurrent stenosis <3 cm in third fase studies. The short and medium term results are promising with a success rate of more than 65 %.
Conclusions: Paclitaxel coated balloon dilation can be used safely in pediatric patients with urethral stenosis, achieving resolution of obstruction.
References
Santucci RA, Joyce GF, Wise M. Male Urethral Stricture Disease. The Journal of Urology. 2007; https://doi.org/10.1016/j.juro.2007.01.041.
Barratt R, Chan G, La Rocca R, Dimitropoulos K, Martins FE, Campos-Juanatey F, et al. Free Graft Augmentation Urethroplasty for Bulbar Urethral Strictures: Which Technique Is Best? A Systematic Review. European Urology. 2021;80(1): 57–68. https://doi.org/10.1016/j.eururo.2021.03.026.
Bullock TL, Brandes SB. Adult Anterior Urethral Strictures: A National Practice Patterns Survey of Board Certified Urologists in the United States. The Journal of Urology. 2007; https://doi.org/10.1016/j.juro.2006.09.052.
Anger JT, Buckley JC, Santucci RA, Elliott SP, Saigal CS. Trends in Stricture Management Among Male Medicare Beneficiaries: Underuse of Urethroplasty? Urology. 2011;77(2): 481–485. https://doi.org/10.1016/j.urology.2010.05.055.
Wessells H, Angermeier KW, Elliott S, Gonzalez CM, Kodama R, Peterson AC, et al. Male Urethral Stricture: American Urological Association Guideline. The Journal of Urology. 2017;197(1): 182–190. https://doi.org/10.1016/j.juro.2016.07.087.
Steenkamp JW, Heyns CF, de Kock ML. Internal urethrotomy versus dilation as treatment for male urethral strictures: a prospective, randomized comparison. The Journal of Urology. 1997;157(1): 98–101.
Santucci R, Eisenberg L. Urethrotomy has a much lower success rate than previously reported. The Journal of urology. 2010;183(5). https://doi.org/10.1016/j.juro.2010.01.020.
Pansadoro V, Emiliozzi P. Internal urethrotomy in the management of anterior urethral strictures: long-term followup. The Journal of urology. 1996;156(1). https://pubmed.ncbi.nlm.nih.gov/8648841/
Elterman DS, Coutinho K, Hagedorn JC. How I Do It: The Optilume drug-coated balloon for urethral strictures. The Canadian Journal of Urology. 2020;27(4): 10322–10328.
Virasoro R, DeLong JM, Estrella RE, Pichardo M, Rodriguez Lay R, Espino G, et al. A Drug-Coated Balloon Treatment for Urethral Stricture Disease: Three-Year Results from the ROBUST I Study. Research and Reports in Urology. 2022;14: 177–183. https://doi.org/10.2147/RRU.S359872.
Elliott SP, Coutinho K, Robertson KJ, D’Anna R, Chevli K, Carrier S, et al. One-Year Results for the ROBUST III Randomized Controlled Trial Evaluating the Optilume® Drug-Coated Balloon for Anterior Urethral Strictures. The Journal of Urology. 2022; https://doi.org/10.1097/JU.0000000000002346.
Downloads
Published
Issue
Section
License
Copyright (c) 2024 Revista Mexicana de Urología
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
