Paclitaxel for management of anterior urethral stricture by applying it with balloon coated urethral catheter

Abstract

Background. Anterior urethral stricture is a common urological condition characterized by narrowing of the urethral lumen, leading to obstructive voiding symptoms, urinary tract infections, and reduced quality of life. Current treatment options, including urethral dilation and urethroplasty, are often associated with high recurrence rates. Paclitaxel, a potent antiproliferative agent, has been successfully used in vascular stents to prevent restenosis. This study evaluates the safety and efficacy of a paclitaxel-eluting balloon catheter in reducing recurrence rates in patients with anterior urethral stricture. Materials and methods. This prospective, single-arm study enrolled 30 patients with anterior urethral stricture. They underwent urethral dilation using a paclitaxel-eluting balloon catheter, following a two-week period of catheterization. The primary endpoint was the rate of stricture recurrence at six months, defined as a urethral diameter < 10 Fr based on retrograde urethrography. Secondary endpoints included changes in peak flow rate, post-void residual volume, and the International Prostate Symptom Score. Results. The mean age of patients was 43.2 years, and the mean stricture length was 2.5 cm. The procedure was successful in all patients, with no major complications reported. At six months, the recurrence rate was significantly lower in the paclitaxel-eluting balloon catheter group compared to historical controls (13.3 vs. 60 %, p < 0.001). Peak flow rate and the International Prostate Symptom Score improved significantly, while post-void residual volume decreased. No patient experienced urethral injury or infection. Conclusions. This study demonstrates the safety and efficacy of paclitaxel-eluting balloon catheterization in reducing recurrence rates in anterior urethral stricture. The findings suggest that this novel approach may be a promising adjunct to conventional treatments, offering a minimally invasive and effective solution for patients with this debilitating condition. Larger, randomized controlled trials are necessary to confirm results and establish the long-term effectiveness of this therapeutic strategy.