What is the Optilume procedure?
Optilume (called “Optilume® BPH Catheter System”) is a drug-coated balloon. It is inserted into your urethra via a minimally invasive, outpatient endoscopic procedure to treat your urethral strictures. Strictures are scarring in the urethra. The effect of this scarring is that your urethra will become narrower. As a result, less urine comes out when you urinate (pee).
When we say “endoscopic”, we mean that your surgeon will use an endoscope: a medical device that looks like a thin tube. The endoscope will have a light and a lens, allowing your doctor to see inside your body. It may also include other tool attachments.
Who is the ideal Optilume candidate?
Optilume is an excellent, minimally invasive outpatient procedure for treating short, less severe urethral strictures before considering more invasive surgical options.
How is Optilume performed?
Optilume can be performed under light sedation or general anesthesia. Using a small camera, a wire is placed across the urethra, and the Optilume balloon is threaded through the stricture.
The balloon is then inflated, dilating and widening your stricture. In addition, the Optilume balloon is coated in a drug that prevents cell proliferation (more cells growing) to avoid your stricture from re-forming.
What is the success rate for Optilume?
The Optilume drug-coated balloon is an effective, minimally invasive treatment option. For most patients, roughly 70%, significant symptom relief is achieved for at least 3 years after the procedure without retreatment.
What are its risk factors?
Most complications are mild and temporary, with studies showing minimal serious device-related complications. But the Optilume procedure does have several potential risks that can include:
- Blood in the urine (hematuria).
- Temporary urinary retention requiring catheterization.
- Painful urination (dysuria).
- Urinary tract infections.
- Bleeding from the urethra.
- Increased urinary urgency.
- Urinary incontinence.
- Pelvic pain.
- Ejaculatory dysfunction.
- Inflammation of the genitourinary system (such as prostatitis or orchitis).
- Fever.
- And in very rare cases, injury or perforation to the urethra or bladder.
How painful is Optilume?
Optilume is generally well-tolerated with minimal pain reported by most patients. Overall, Optilume is considered a minimally invasive treatment with low pain levels, as reported by most patients. Using local anesthesia and light sedation helps keep patients comfortable during the procedure.
Here’s what you can expect regarding discomfort during and after the procedure:
During the procedure
- Most patients experience mild to moderate discomfort when the balloon is expanded in the urethra.
- 70% of patients report some discomfort at one point during the procedure.
- The mean (middle) pain score reported is 2.8 out of 10, and 100% of patients agreed that the procedure was tolerable with local anesthetic.
- Some patients describe the balloon expansion as “discomfort” rather than pain.
After the procedure
- Most patients experience minimal downtime and can return to normal activities within a few days.
- Some mild discomfort may be present, but it typically subsides quickly.
- Only 20% of patients required simple analgesia (pain relief) after the procedure.
- Patients may experience some blood in the urine and discomfort associated with dilation, which usually resolves within one to two weeks.
What is the recovery like after Optilume?
As a minimally invasive endoscopic procedure, recovery from Optilume is minimal. Patients do not require hospitalization for this procedure. Postoperatively, patients typically require a catheter, which is usually in place for about three days.
Are there alternative procedures to consider for treating urethral strictures?
Yes, other endoscopic procedures can be considered depending on your specific disease. One such treatment option is direct vision internal urethrotomy (DVIU). The DVIU procedure cuts open your stricture to widen your urethra. Another procedure is urethroplasty. In this technique, your surgeon will reconnect the two ends of your urethra after removing your stricture.
What makes Tower Urology unique for Optilume procedures in Los Angeles?
Urethral strictures are challenging to manage primarily because they have a high recurrence rate and can significantly affect your quality of life.
Optilume significantly improves our endoscopic urologic care options for treating mild to moderate urethral strictures. Optilume should be considered for the correct patients before proceeding to more definitive and invasive options, which carry more significant complications.
We invite you to establish care with Tower Urology.
Tower Urology is conveniently located for patients throughout Southern California and the Los Angeles, including Beverly Hills, Santa Monica, West Los Angeles, West Hollywood, Culver City, Hollywood, Venice, Marina del Rey, Burbank, Glendale, and Downtown Los Angeles.
Our Los Angeles urologists provide state-of-the-art treatment for many urologic conditions. Tower Urology is one of California’s leading treatment providers for most men’s and women’s urological healthcare conditions. For men, in addition to Optilume, these include erectile dysfunction. overactive bladder, prostate cancer, prostate enlargement, pelvic floor disorders, and penile prosthesis, to name a few.
Optilume FAQs
As of March 2025, Optilume for urethral strictures is covered by Medicare.
Optilume and UroLift are both minimally invasive treatments for urinary issues, but they address different conditions and work in distinct ways:
Optilume is primarily designed to treat urethral strictures (narrowing of the urethra due to scar tissue). It uses a balloon that mechanically dilates the urethra and delivers medication (paclitaxel) to prevent scar tissue from reforming.
UroLift is a BPH treatment (meaning it is for patients with benign prostatic hyperplasia or enlarged prostate). It is a permanent implant to “lift” and hold prostate tissue away from the urethra, creating an open channel for urine flow.
The key difference is that Optilume treats urethral strictures with a drug-coated balloon, while UroLift treats enlarged prostates using permanent implants to hold tissue back.
Sources
Optilume for anterior urethral strictures
https://www.nice.org.uk/advice/mib241/chapter/The-technology
One-year outcomes after treatment with a drug-coated balloon catheter system for lower urinary tract symptoms related to benign prostatic hyperplasia
https://www.nature.com/articles/s41391-021-00362-z
BPH catheter system shows encouraging outcomes in pilot trial
https://www.urologytimes.com/view/bph-catheter-system-shows-encouraging-outcomes-in-pilot-trial
The PINNACLE Study: A Double-blind, Randomized, Sham-controlled Study Evaluating the Optilume BPH Catheter System for the Treatment of Lower Urinary Tract Symptoms Secondary to Benign Prostatic Hyperplasia
https://www.auajournals.org/doi/10.1097/JU.0000000000003568
