Baseline characteristics of men undergoing drug-coated balloon dilation, urethrotomy, or urethroplasty for urethral stricture

Authors

• Melvin Zarghooni, University of Texas Health Science Center at HoustonFollow
• Hoi Doan, University of Texas Health Science Center at HoustonFollow
• Adithya Chandrasekaran, University of Texas Health Science Center at HoustonFollow
• Travis Green, University of Texas Health Science Center at HoustonFollow
• Rodrigo Donalisio da SilvaFollow
• Annie Chen, University of Texas Health Science Center at HoustonFollow

Publication Date

2026

Abstract

Drug-coated balloon (DCB) dilation, direct vision internal urethrotomy (DVIU), and urethroplasty are used to treat urethral stricture in men. Understanding how patients differ across these procedures, and between those who are and are not retreated, is needed to interpret retreatment outcomes. We described baseline characteristics of men undergoing each procedure, overall and by 12-month retreatment status.

Using Epic Cosmos, a national database of 310 million patients, we identified men with urethral stricture who underwent an index DCB, DVIU, or urethroplasty in 2024-2025, grouped by procedure and 12-month retreatment. We described age, comorbidities, smoking, anticoagulant use, lichen sclerosus, residence, and preoperative work-up. Adequate preoperative work-up was defined as retrograde urethrogram, cystoscopy, or uroflowmetry within 1 year before the index procedure; rural/urban status used Rural-Urban Commuting Area (RUCA) codes. Analyses were descriptive.

Retreated and non-retreated patients numbered 809 and 11,995 for DCB, 949 and 9,742 for DVIU, and 269 and 4,310 for urethroplasty (Table 1). Average age was 68-69 years for DCB and DVIU and 57 for urethroplasty, regardless of retreatment status. Hypertension (68-71% vs 51-55%) and diabetes (26-30% vs 20-25%) were more frequent with DCB and DVIU than urethroplasty, whereas anticoagulant use was higher with urethroplasty (42-47% vs 29-32%). Lichen sclerosus was more frequent with urethroplasty (6.9-7.8%) than DCB (1.5-3.3%) or DVIU (0.9%, non-retreated). Adequate work-up was documented for 74-80% of urethroplasty, 48-57% of DCB, and 41% of DVIU patients; residence was 91-95% urban across groups. DVIU retreated and non-retreated patients were similar. DCB-retreated patients had more obesity (41.4% vs 34.3%) and lichen sclerosus (3.3% vs 1.5%) and less adequate work-up (48.2% vs 57.1%). Urethroplasty-retreated patients had less adequate work-up (74.0% vs 80.4%).

Men undergoing urethroplasty were younger, had less hypertension and diabetes, and more often had a documented preoperative work-up than men undergoing DCB or DVIU. Retreated and non-retreated patients were largely similar within each procedure, with modest numeric differences among DCB patients. These descriptive findings provide context for interpreting retreatment outcomes; further study is needed.

Keywords

DCB, Urethral Stricture

Published Open-Access

no

Recommended Citation

Zarghooni, Melvin; Doan, Hoi; Chandrasekaran, Adithya; et al., "Baseline characteristics of men undergoing drug-coated balloon dilation, urethrotomy, or urethroplasty for urethral stricture" (2026). Faculty, Staff and Student Publications. 4537.
https://digitalcommons.library.tmc.edu/uthmed_docs/4537