Optilume Drug-Coated Balloon for Bladder Neck Contracture Following Pulsed Thulium:YAG Laser Enucleation of the Prostate: A Single-Institution Retrospective Case Series.

Authors

Troy M Sofinowski, Greyson Holler, Gabriel Fiscus, W Patrick Springhart, Tim Large

Published in

Journal of endourology. Pages 8927790261497133. Oct 12, 2026. Epub Oct 12, 2026.

Abstract

Bladder neck contracture (BNC) following anatomical endoscopic enucleation of the prostate (AEEP) occurs in approximately 3% of cases and carries high recurrence rates after standard endoscopic management. The Optilume drug-coated balloon (DCB) delivers paclitaxel at dilation but has not been reported for post-enucleation BNC. We describe the first such series following pulsed thulium laser enucleation of the prostate (p-ThuLEP).
We retrospectively reviewed 10 consecutive patients with cystoscopically confirmed BNC after p-ThuLEP at a single high-volume center (IRB 2425566-1). All underwent laser enucleation of bladder neck scar followed by Optilume DCB dilation. Data were abstracted from the electronic health record.
Median age was 74 years (range 59-89). Median pre-p-ThuLEP prostate volume was 80 cc (range 36-100, n = 8). BNC presented at a median of 5.8 months after p-ThuLEP (range 2.7-12.0). A 36F balloon was used in nine patients and a 26F balloon in one, at 8 to 11 atm for 5 minutes. At a median follow-up of 5.2 months (range 0.9-15.1), no patient required reintervention (0% recurrence). Cystoscopy, performed in 5 of 10 on clinical indication, showed a patent bladder neck in all. Median post-procedure Qmax was 14.1 mL/s (n = 7), and post-void residual was 23.5 mL (n = 10). Thirty-day complications after Optilume occurred in two patients (20%), both Clavien-Dindo Grade II: gross hematuria with clot retention managed by continuous bladder irrigation and urinary tract infection.
Optilume DCB following laser enucleation of post-p-ThuLEP BNC appears safe and feasible with encouraging short-term patency. Median follow-up (5.2 months) is shorter than the median interval to BNC presentation (5.8 months); thus, these short-term data do not establish durability. To the best of the authors' knowledge, this is the first report of Optilume DCB outcomes for BNC specifically following AEEP. A prospective cohort trial with longer follow-up is warranted.

PMID:
42861848
Bibliographic data and abstract were imported from PubMed on 12 Oct 2026.

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