Assessment of a new transurethral balloon dilation catheter in the treatment of urethral stricture disease

Objectives. To assess a newly designed balloon dilation catheter for the tr eatment of urethral stricture disease. The dilating capability of the cathe ter, the tolerability and safety of the procedure, and its short-term effic acy were evaluated. Methods. Fifty-one patients with urethral strictures underwent dilation wit h the UrethraMax or a coude tip balloon dilation catheter. Efficacy paramet ers included measurement of the American Urological Association symptom sco re and maximum urinary flow rate 3, 6, and 12 months after treatment. The a dequacy of dilation and the degree of mucosal trauma and hematuria were ass essed endoscopically, and patient pain was measured using a visual analog s cale. Results. Forty-three patients (84.3%) were successfully dilated, achieving a urethral caliber of 20F or greater. Dilation resulted in statistically si gnificant improvements in both the mean American Urological Association sym ptom score and mean maximum urinary flow rate at 3 and 6 months. Mucosal tr auma was mild in all but 4 cases, and no patient developed significant hema turia. The mean visual analog pain score was 3.9 (range 0.1 to 9.4). Conclusions. Balloon dilation is a safe, well-tolerated, office-based proce dure that theoretically offers several advantages over sequential rigid dil ation and internal urethrotomy. It is associated with minimal complications , and its short-term efficacy is acceptable. We regard this as the dilation procedure of choice and first-line therapy for most strictures. (C) 2000, Elsevier Science Inc.