Optilume drug-coated balloon dilation for treatment of post-prostate cancer ablative therapy urethral stricture: a case series.

Background: Optilume-drug coated balloon as emerged as a less invasive management of recurrent bulbar urethral strictures. Data is still emerging in terms of its efficacy with regards to other stricture types. Additionally, ablative therapies (whether focal or whole gland) are also becoming more common for management of prostate cancer. As these treatments progress, we, as a specialty, will see more complications from these to include urethral strictures. This series demonstrates the use of the Optilume drug-coated balloon (DCB) dilation system for the treatment of urethral stricture disease after prostate ablative therapy for treatment of prostate cancer. Case Description: Two patients involved men who had focal therapy with transurethral ultrasound ablation (TULSA) for treatment of localized prostate cancer who developed intraprostatic or membranous urethral stricture disease after treatment. The other two patients in our case series had ablative therapy with irreversible electroporation (IRE) for management of their localized prostate cancer and then subsequently developed posterior urethral strictures. All were treated with paclitaxel-coated (Optilume) balloon dilation with good response and no recurrence at up to 14 months after treatment. Conclusions: With new therapies emerging with potential urethral complications, defining potential treatment methods is important. Given the novelty of both treatment modalities, this appears to offer a feasible treatment solution for an uncommon complication.