Definition

Direct vision internal urethrotomy (DVIU) is surgery to repair a narrowed section of the urethra. This is referred to as a stricture. The urethra is the tube that carries urine from the bladder to the outside of the body.

Reasons for Procedure

Urethral stricture is due to scarring of the urethra. This scarring may be caused by infection or injury. DVIU cuts through the scar tissue and opens the urethra.

Urethral stricture can result in:

• Prostate problems in men
• Bladder and kidney infections
• Inability to urinate or empty the bladder completely

Possible Complications

Problems from the procedure are rare, but all procedures have some risk. Your doctor will review potential problems, like:

• Reaction to anesthesia
• Excessive bleeding
• Blood clots
• Infection
• Pain when urinating
• Damage to urethra
• Recurrent stricture
• Need for more procedures
• Penile pain
• Erectile dysfunction

Factors that may increase the risk of complications include:

• Bleeding disorders or taking medications that reduce blood clotting
• Obesity
• Smoking

What to Expect

Prior to Procedure

Your doctor may do the following:

• Conduct a physical exam and ask about your medical history
• Order imaging, blood, and urine tests
• Talk about the anesthesia being used and its potential risks

In the days leading up to the procedure:

• Take a shower before the procedure as directed
• Arrange for a ride home from the hospital
• Do not take anything by mouth starting 8 hours before your procedure

Anesthesia

General or spinal anesthesia will be used. It will block any pain and keep you asleep or sedated through the surgery.

Description of the Procedure

After you are under anesthesia, a special tube called a cystoscope will be placed in your urethra to locate the stricture. Then, a tool is used to cut away the scar tissue inside your urethra to make it wider. The scar tissue may be removed by cutting or using a laser or heat source. A catheter is placed through the urethra into the bladder after surgery.

How Long Will It Take?

About 30 minutes

How Much Will It Hurt?

Anesthesia prevents pain during surgery.

Average Hospital Stay

You will be able to go home the next morning in most cases.

Post-procedure Care

At the Hospital

During recovery immediately after surgery, your vital signs will be monitored. Pain medication will be provided as needed. The catheter will be checked to make sure urine is passing as expected. You will be encouraged to move around and eat before discharge.

At Home

A catheter will be left in place for 3 to 5 days to allow healing and urine flow. You'll return after 3–5 days to have the catheter removed. After 5 days, you’ll be taught Self Clean Intermittent Catheterization (SCIC) in OPD to prevent recurrence of stricture urethra.