Urethrotomy

Urethrotomy is an operation that involves making an incision into the urethra, most often to relieve a stricture, a narrowing of the urethral passage. It is usually performed as an outpatient procedure, with the patient typically discharged from the hospital or surgery center within six hours of the operation. One common form of the procedure, direct visual internal urethrotomy or DVIU, has become a widely used treatment for urethral strictures in men despite poor long term performance: reported success is under nine percent for a first or repeat urethrotomy, most patients experience the stricture return the longer they are followed, and the expected long term success rate approaches zero across every approach. Beginning in 2003, several urology residency programs in the northeastern United States began advocating urethrotomy as the initial treatment for a young patient with a stricture rather than urethral dilation, reasoning that the one to two years of relief the procedure typically provides gives the patient and practitioner time to plan a more effective long term treatment without the judgment clouding effect of repeated dilations, and that, should the patient ultimately choose urethroplasty, the urethrotomy will have left less scar tissue at the stricture site than the more conventional dilation approach would have.