This is a scoping review of the available literature on paclitaxel-coated balloon dilation (DCB) in female urethral strictures. Our objectives are to map all clinical evidence on feasibility, patency rates, continence outcomes, and safety; to summarise study characteristics and patient numbers; and to identify critical knowledge gaps to inform future prospective trials.

We performed a scoping review following PRISMA-ScR and JBI methodology. Four electronic databases (PubMed, Embase, Web of Science, ClinicalTrials.gov) and major urology conference proceedings (2010–April 2025) were searched using “female urethral stricture” AND (“drug-coated balloon” OR “Optilume”). Inclusion criteria encompassed any clinical report—randomised or observational—of paclitaxel-coated balloon dilation in adult women with anatomical urethral stricture. Exclusion criteria were male-only cohorts, purely functional obstruction, and animal or laboratory studies. Two reviewers independently screened titles/abstracts and full texts, then charted study design, sample size, stricture location/length, procedural details, follow-up duration, patency definition, continence outcomes, and adverse events. Data were synthesized narratively and summarised in a table; a PRISMA flow chart depicts study selection.

Four unique clinical reports met inclusion criteria, comprising 28 women with postmenopausal urethral stricture treated with Optilume® DCB:
Case Reports (n=2): Single-patient descriptions with 6-month follow-up showing maintained patency and preserved sphincter function.
Conference Abstract (n=12): AUA PD05-02 series reporting early patency rates >75 % at 6–12 months with no major continence issues.
Single-Centre Cohort (n=14): Springer-published study demonstrating 91.7 % recurrence-free rate at mean 12-month follow-up and only minor balloon-related discomfort.
Follow-up ranged from 6 to 41 months. All reports used standard balloon inflation protocols (30 Fr for 5 minutes) and monitored uroflowmetry, post-void residual, and patient-reported continence. No major complications (stricture recurrence, incontinence, or urethral injury) were documented.

Although limited by small case numbers and heterogeneity in design, the consistently high short-term patency (75–92 %) and absence of serious adverse events suggest that paclitaxel-coated balloon dilation is both feasible and safe in female urethral stricture. Variability in outcome definitions and follow-up intervals, combined with lack of control groups, precludes definitive efficacy conclusions.

This is the first scoping review of DCB use in female urethral strictures, identifying 28 treated patients across four reports. The preliminary evidence—while encouraging—highlights the urgent need for prospective, multicentre, assessor-blinded RCTs with standardised endpoints (e.g., 12-month stricture-free rate, uroflowmetry, continence scoring) to establish high-level evidence and guide future ICS-EUS recommendations.