Company Decision

The ROBUST IV study is designed to collect and better understand "real-world" outcomes for men undergoing urethral dilation using the Optilume Drug Coated Balloon (DCB) for treatment of urethral stricture.

Inclusion Criteria:

1. Male subjects ≥ 18 years old
2. Visual confirmation of stricture via cystoscopy or retrograde urethrogram
3. Single lesion bulbar urethral stricture, less than or equal to 3.0 cm
4. Significant symptoms of stricture such as frequency of urination, dysuria, urgency, hematuria, slow flow, feeling of incomplete emptying, recurrent urinary tract infections (UTIs).
5. IPSS score of 13 or higher
6. Lumen diameter <12F by urethrogram
7. Able to complete validated questionnaire independently
8. Qmax <15 ml/sec
9. Guidewire must be able to cross the lesion

Exclusion Criteria:

1. Strictures greater than 3.0 cm long
2. Subjects with greater than 1 stricture.
3. Sensitivity to paclitaxel or on medication that may have negative interaction with paclitaxel
4. Previous urethroplasty within the anterior urethra
5. Stricture due to bacterial urethritis
6. Stricture due to untreated gonorrhea
7. Stricture due to Lichen Sclerosus, or balanitis xerotica obliterans (BXO)
8. Stricture dilated or incised within the last 3 months (apart from subjects on self-catheterization)
9. Presence of local adverse factors (e.g. abnormal prostate, urethral false passage or fistula) making catheterization difficult
10. Presence of signs of obstructive voiding symptoms not directly attributable to the stricture at the discretion of the physician
11. Diagnosis of untreated and unresolved severe BPH or bladder neck contracture (BNC), at the discretion of the physician
12. Prior diagnosis of overactive bladder (OAB)
13. Diagnosis of severe stress urinary incontinence (SUI), at the discretion of the physician
14. Previous radical prostatectomy that resulted in either unresolved bladder neck contracture (BNC) and/or unresolved incontinence
15. Previous pelvic radiation
16. Diagnosis of kidney, bladder, urethral or ureteral stones in the last 6 weeks or active stone passage in the past 6 weeks
17. Diagnosed with chronic renal failure, at the discretion of the physician
18. A dependence on Botox (onabotulinumtoxinA) in the urinary system
19. Presence of a penile implant, artificial urinary sphincter, or stent(s) in the urethra or prostate
20. Known neurogenic bladder, sphincter abnormalities, or poor detrusor muscle function
21. Previous hypospadias repair
22. Diagnosis within the last 5 years of carcinoma of the bladder or prostate or suspicion of prostate cancer (e.g. abnormal DRE or high PSA) at the discretion of the physician
23. Any cognitive or psychiatric condition that interferes with or precludes direct and accurate communication with the study investigator regarding the study or affect the ability to complete the study quality of life questionnaires
24. Unwilling to use protected sex for ≥30 days post treatment
25. Unwilling to abstain or use protected sex for 90 days post treatment if sexual partner is of child bearing potential.
26. Inability to provide legally effective Informed Consent Form (ICF) and/or comply with all the required follow-up requirements
27. Active infection in the urinary system
28. History of diabetes not controlled with a hemoglobin A1-C >7.0%
29. Diagnosed or suspected primary neurologic conditions such as multiple sclerosis or Parkinson's disease or other neurological diseases known to affect bladder function, sphincter function or poor detrusor muscle function.
30. Visible hematuria with subject urine sample without known contributing factor