Optilume for Urethral Strictures
Infections, inflammation, prior surgeries, or trauma can cause scarring in the urethra, leading to narrowing and restricted urine flow. Even after treatment, strictures often recur or persist.
Optilume is a drug-coated balloon (DCB) therapy that combines mechanical dilation with localized delivery of paclitaxel – a medication that helps prevent scar tissue from reforming. The balloon gently expands the strictured area, while the drug works to maintain long-term patency and reduce recurrence.
This quick, outpatient procedure offers lasting symptom relief without incisions, implants, or repeat surgery.
What Is Urethral Stricture Disease?
Urethral stricture disease happens when scarring causes a narrowing in the urethra – the tube that carries urine out of the body. This narrowing blocks or restricts urine flow, making it difficult or painful to urinate, can cause spraying of the urine and in some cases, can prevent urination altogether. If left untreated, strictures can lead to urinary tract infections, bladder dysfunction, or even kidney damage.
Anterior vs. Posterior Strictures
There are two main types of urethral strictures, depending on where the narrowing occurs:
Posterior strictures affect the first few inches of the urethra, closer to the bladder. These are often caused by serious injuries, such as pelvic fractures, that may have resulted in a complete disruption of urine flow. They typically require more complex surgical intervention.
Anterior strictures occur farther along the urethra, toward the tip of the penis. These are more common and are often caused by catheter use, inflammation, or trauma (like straddle injuries). Optilume is designed specifically to treat recurrent anterior urethral strictures in a minimally invasive way.
Optilume for Urethral Strictures
Optilume is a minimally invasive outpatient treatment designed specifically for recurrent anterior urethral strictures.
It combines mechanical dilation of the scarred or narrow segment, with localized delivery of paclitaxel, a drug that helps prevent scar tissue from reforming. The treatment is delivered via a drug-coated balloon (DCB), which is inserted into the urethra and then inflated to widen the narrowed area while simultaneously delivering medication to reduce the risk of recurrence.
How It’s Different
Unlike traditional treatments such as:
- Dilation, which often requires repeat procedures,
- Urethrotomy, which involves cutting the stricture and carries a high rate of recurrence, or
- Urethroplasty, which is a more invasive surgical reconstruction,
Optilume is a single-session, non-surgical option that can offer long-term symptom relief with significantly lower recurrence rates. The use of paclitaxel helps maintain the urethral opening after the mechanical dilation, which sets it apart from treatments that only treat the narrowing without addressing the underlying scar formation.
Canada’s First Optilume Provider
UUA was the first clinic in Canada to offer Optilume for urethral strictures, making us the most experienced center in the country for this treatment.
Optilume Success Rate
After one year, 3 out of 4 patients who received the Optilume DCB treatment were stricture-free. These men, who had failed prior traditional endoscopic treatments, experienced a 290% improvement in urinary flow, a 75% reduction in symptoms and suffered zero serious complications.
Source: One-Year Safety and Efficacy Outcomes on a Novel Drug Coated Balloon (DCB) for Urethral Stricture Disease – The ROBUST I Study G. H. Jordan et al.
The Process
Consultation & Diagnosis
We begin with a thorough review of your symptoms, medical history, and prior treatments. Diagnostic imaging or tests may be ordered to confirm the diagnosis and ensure that Optilume is the right option for you.
The Procedure
The treatment is performed under sedation or regional anesthesia, and typically takes just minutes. A drug-coated balloon catheter is inserted into the urethra and gently inflated. The balloon dilates the narrowed segment and delivers paclitaxel – a medication that helps reduce scarring and prevent recurrence.
Recovery & Follow-Up
Patients are discharged the same day and can typically return to normal activities within a few days. You’ll be scheduled for follow-up appointments to monitor your progress and ensure lasting results.
Patients with recurrent anterior urethral strictures or those who have previously undergone dilation or urethrotomy and are looking for a non-surgical, durable solution may be eligible. Your doctor will assess your specific case.
Most men resume normal activity within a few days. A short catheterization period may be required. You’ll receive complete post-procedure instructions.
Clinical studies show lasting symptom relief in the majority of patients after one year, with significantly reduced recurrence compared to traditional treatments.
The procedure is performed under anesthesia to ensure comfort. Mild discomfort after the procedure is normal and manageable.
Optilume is less invasive and does not require cutting or surgical reconstruction. While urethroplasty may be needed for more complex cases, Optilume offers a lower-risk option for many men with recurrent anterior strictures.
If your stricture recurs, your doctor will re-evaluate your treatment options. Optilume can sometimes be repeated or followed by other treatments if necessary.
No, Optilume is a private-pay procedure and is not covered by OHIP or private insurance.
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