MP64-08 PILOT STUDY OF PACLITAXEL-COATED BALLOON DILATION OF POST-PHALLOPLASTY URETHRAL STRICTURE

You have accessJournal of UrologyReconstruction: External Genitalia and Urotrauma (Including Transgender Surgery and Traumatic Fistula) II (MP64)1 May 2024MP64-08 PILOT STUDY OF PACLITAXEL-COATED BALLOON DILATION OF POST-PHALLOPLASTY URETHRAL STRICTURE Brenna L. Briles, Ashley Deleon, Curtis Crane, and Richard A. Santucci Brenna L. BrilesBrenna L. Briles , Ashley DeleonAshley Deleon , Curtis CraneCurtis Crane , and Richard A. SantucciRichard A. Santucci View All Author Informationhttps://doi.org/10.1097/01.JU.0001008824.92877.7f.08AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Simple dilation of urethral strictures has been proven ineffective in the cismale and post phalloplasty populations. However, a novel paclitaxel-coated urethral balloon dilator has shown unexpectedly good results in the treatment of cismale strictures, achieving a shocking 3 year success rate of 77%. This new treatment was applied to an intended 22 patients with post phalloplasty strictures, as a pilot study to determine its efficacy. Most post-phalloplasty urethral strictures are found at the distal anastomosis, at the connection point between the pars fixa (labia minora) and penile (skin flap) urethra. All patients had short strictures in this area that would otherwise would have required open surgical repair. METHODS: All patients had pre intervention IPSS (International Prostate Symptom Score) and uroflow determinations. Strictures were dilated up to 24 F with an uncoated balloon dilator, then dilated to 30 F with the paclitaxel coated balloon, per manufacturer's instructions. Urinary catheters were not placed. Strictures were uniformly tight, narrowly fitting a 0.038 inch guidewire, and with an estimated circumference of 1-3 F. RESULTS: 21 patients completed the study to date. The mean pre intervention IPSS was 27 (severe symptoms). The mean uroflow maximum was 7 ml/second, including 3 patients who could not void at all and had a suprapubic tube in place for urinary retention. 7/21 (33%) of patients failed definitively and required subsequent open urethroplasty, with a mean follow up of 306 days (range up to 528 days). CONCLUSIONS: Post phalloplasty stricture patients treated with a paclitaxel-coated urethral balloon dilation had a certain failure rate of 33%, but in 67% of patients, prolonged unobstructed voiding was achieved without the need for open surgical intervention. Longer follow up, and better definition of the ideal treatment window after phalloplasty will be required. There are currently no effective nonoperative treatment methods for urethral stricture, and the potential to obviate complicated urethroplasty in some cases without the need for open surgery will be a welcome addition to the treatment armamentarium. Even when not curative, balloon dilation was beneficial as a minimally invasive, safe method to temporize patients with highly symptomatic strictures until curative urethroplasty could be arranged. Source of Funding: None © 2024 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 211Issue 5SMay 2024Page: e1044 Advertisement Copyright & Permissions© 2024 by American Urological Association Education and Research, Inc.Metrics Author Information Brenna L. Briles More articles by this author Ashley Deleon More articles by this author Curtis Crane More articles by this author Richard A. Santucci More articles by this author Expand All Advertisement PDF downloadLoading ...