Urethral Stricture Treatment Melbourne
Optical urethrotomy (also known as direct vision internal urethrotomy or DVIU) is a minimally invasive procedure to treat urethral strictures - abnormal narrowing of the urethra that restricts urine flow. Using a special cystoscope with a built-in blade, the stricture is cut open under direct vision to widen the urethral channel. This procedure is typically offered as first-line treatment for short, uncomplicated urethral strictures.
Written and clinically reviewed by Dr Brendan Dias
Consultant Urologist & Robotic Surgeon · MBBS, MS (General Surgery), DrNB (Urology), IntFRCS (England), FUSANZ, FRACS (Urology)
Last clinically reviewed: 26 August 2026
Benefits
- Minimally invasive with no external incisions
- Quick procedure typically taking 15-30 minutes
- Immediate improvement in urine flow
- Day case procedure - go home the same day
- Can be combined with self-catheterisation to maintain results
- Avoids more complex open reconstructive surgery
The Procedure
Optical urethrotomy is performed under general or spinal anaesthesia. A urethroscope is passed into the urethra to visualise the stricture. Using a cold knife blade or laser, one or more cuts are made through the scar tissue at the 12 o'clock position to open the narrowed segment. The urethroscope is then advanced past the treated area to ensure the urethra is patent throughout its length. A catheter is left in place for 1-3 days to allow healing with the urethra held open.
Who Is a Candidate?
Optical urethrotomy is most effective for short strictures (less than 1-2cm), first-time strictures, strictures in the bulbar urethra (the segment between the prostate and penis), and patients not suitable for more extensive reconstructive surgery. Recurrent strictures or long/complex strictures may require open urethroplasty for better long-term outcomes.
Recovery
Most patients go home the same day or the following day once the catheter is removed. You may have mild burning and blood in the urine for 1-2 weeks. Avoid strenuous activity for 1 week. Some patients are taught intermittent self-catheterisation to maintain the urethra open during healing - this significantly reduces recurrence rates. Follow-up flow rate testing monitors the success of the procedure.
Risks & Considerations
The main limitation of optical urethrotomy is stricture recurrence, which occurs in 50-70% of cases over time, particularly for longer or recurrent strictures. Other risks include bleeding, urinary tract infection, failure to pass the stricture requiring alternative treatment, and rarely urethral false passage. Repeated urethrotomies may make future reconstructive surgery more difficult.