{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T21:25:04Z","timestamp":1768512304316,"version":"3.49.0"},"reference-count":12,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T00:00:00Z","timestamp":1768435200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"\n Urethral strictures that are not related to urological procedures or severe urethral trauma are rare in the pediatric population. Potential etiological factors include bladder catheterization during advanced surgical procedures and in intensive care units. We present the first reported off-label, minimally invasive treatment of a long-segment anterior urethral stricture in a teenager following cardiac surgery, using a paclitaxel-coated balloon (Optilume\u2122). During the diagnosis of urethral stricture, cystoscopy and urethral biopsy were performed, which ruled out balanitis xerotica obliterans on histopathological examination. After mechanical dilation of the urethra to 18Fr over a period of two months, restenosis was observed, confirmed by uroflowmetry, with a\n Q<\/jats:italic>\n max<\/jats:sub>\n of 4.6\u2005mL\/s and a voided volume of 202.9\u2005mL. An 18Fr (6\u2005mm) balloon with a length of 50\u2005mm was used during the treatment. The procedure was performed under fluoroscopic guidance, without the use of a cystoscope sheath, using a 0.038\u2033 OTW guidewire. The balloon was inflated to a pressure of 10 atm for 5\u2005min. After the procedure, a 14Fr Foley catheter was left in place for 72\u2005h. The perioperative course was uneventful, with no local or systemic reactions. Uroflowmetry performed 72\u2005h after the procedure showed a\n Q<\/jats:italic>\n max<\/jats:sub>\n of 20.7\u2005mL\/s with a voided volume of 283.5\u2005mL. At the 3-month follow-up,\n Q<\/jats:italic>\n max<\/jats:sub>\n was 19.6\u2005mL\/s with a voided volume of 219.7\u2005mL, and at 8 months follow-up,\n Q<\/jats:italic>\n max<\/jats:sub>\n was 18.4\u2005mL\/s with a voided volume of 160.5\u2005mL, without post-void residual urine. There are currently no published studies in the pediatric literature evaluating treatment with drug-coated balloons (DCBs). According to the EAU\/ESPU guidelines, there are no dedicated recommendations for the management of urethral strictures in children, as this condition is rare in the pediatric population and requires individualized treatment, especially in children with significant comorbidities. Optilume\u2122 may represent a potential safe, minimally invasive therapeutic option to consider only in exceptional, carefully selected pediatric cases. However, this off-label use requires careful counseling, and long-term follow-up to assess the durability and late safety outcomes.\n <\/jats:p>","DOI":"10.3389\/fped.2025.1737866","type":"journal-article","created":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T06:25:28Z","timestamp":1768458328000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Off-label use of drug-coated balloon (Optilume\u2122) for urethral stricture in a 16-year-old boy: the FIRST pediatric case report"],"prefix":"10.3389","volume":"13","author":[{"given":"Klaudia","family":"Korlacka","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piotr","family":"Bryniarski","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"5","DOI":"10.3389\/fped.2019.00005","article-title":"Anterior urethral strictures in children: disease etiology and comparative effectiveness of endoscopic treatment vs. open surgical reconstruction","volume":"7","author":"Vetterlein","year":"2019","journal-title":"Front Pediatr"},{"key":"B2","doi-asserted-by":"publisher","first-page":"444","DOI":"10.4274\/jpr.galenos.2021.83604","article-title":"Pediatric urethral strictures and management strategies; an evolving and learning experience","volume":"8","author":"Fahiem-ul-Hassan","year":"2021","journal-title":"J Pediatr Res"},{"key":"B3","doi-asserted-by":"publisher","first-page":"403.e1","DOI":"10.1016\/j.jpurol.2019.05.020","article-title":"Etiology and characteristics of pediatric urethral strictures in a developing country in the 21st century","volume":"15","author":"Ansari","year":"2019","journal-title":"J Pediatr Urol"},{"key":"B4","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1111\/jdv.13136","article-title":"Evidence-based (S3) guideline on (anogenital) lichen sclerosus","volume":"29","author":"Kirtschig","year":"2015","journal-title":"J Eur Acad Dermatol Venereol"},{"key":"B5","doi-asserted-by":"publisher","first-page":"366","DOI":"10.1002\/bco2.312","article-title":"Optilume drug-coated balloon for anterior urethral stricture: 2-year results of the ROBUST III trial","volume":"5","author":"VanDyke","year":"2023","journal-title":"BJUI Compass"},{"key":"B6","doi-asserted-by":"publisher","first-page":"90","DOI":"10.1097\/JU.0000000000004229","article-title":"Long-term outcomes of recurrent bulbar urethral stricture treatment with the optilume drug-coated balloon: five-year results from the ROBUST I study","volume":"213","author":"DeLong","year":"2025","journal-title":"J Urol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"177","DOI":"10.2147\/RRU.S359872","article-title":"A drug-coated balloon treatment for urethral stricture disease: three-year results from the ROBUST I study","volume":"14","author":"Virasoro","year":"2022","journal-title":"Res Rep Urol"},{"key":"B8","doi-asserted-by":"publisher","first-page":"21","DOI":"10.48083\/MLXK5817","article-title":"One-year outcomes of the ROBUST II study evaluating the use of a drug-coated balloon for treatment of urethral stricture","volume":"3","author":"DeLong","year":"2022","journal-title":"Soc Int Urol J"},{"key":"B9","doi-asserted-by":"publisher","first-page":"69","DOI":"10.1016\/s0022-3468(85)80396-1","article-title":"Postcatheterization urethral strictures following cardiac surgery in children","volume":"20","author":"Prabhu","year":"1985","journal-title":"J Pediatr Surg"},{"key":"B10","volume-title":"European Association of Urology (EAU) Guidelines Panel on Urethral Strictures","author":"Lumen","year":""},{"key":"B11","doi-asserted-by":"publisher","first-page":"O34","DOI":"10.1111\/luts.12208","article-title":"Management of urethral stricture: high-pressure balloon dilation versus optical internal urethrotomy","volume":"11","author":"Kumano","year":"2019","journal-title":"Low Urin Tract Symptoms"},{"key":"B12","doi-asserted-by":"publisher","first-page":"722","DOI":"10.1631\/jzus.B1600096","article-title":"High-pressure balloon dilation for male anterior urethral stricture: single-center experience","volume":"17","author":"Yu","year":"2016","journal-title":"J Zhejiang Univ Sci B"}],"container-title":["Frontiers in Pediatrics"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1737866\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,15]],"date-time":"2026-01-15T06:25:40Z","timestamp":1768458340000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fped.2025.1737866\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,15]]},"references-count":12,"alternative-id":["10.3389\/fped.2025.1737866"],"URL":"https:\/\/doi.org\/10.3389\/fped.2025.1737866","relation":{},"ISSN":["2296-2360"],"issn-type":[{"value":"2296-2360","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,15]]},"article-number":"1737866"}}