Internal urethrotomy/visual internal urethrotomy (VIU)/optical internal urethrotomy(OIU) is a endoscopic procedure in which stricture is cut open using a cold knife. There is a small blade towards the tip of the instrument that can be used to cut the stricture internally.
Subsequently, an indwelling catheter is placed to stent the urethra open for some period of time (3-5 days) as the urethra heals. This procedure is not meant to remove the scar tissue or a “clean out” procedure for urethra. In this an incision is made into the scar tissue (Stricture) of urethra and recovery is expected by growth of normal mucosal layer (epithelialization) into the wound.
But unfortunately in most cases wound contraction occur and scar is replaced by further scarring and recurrent stricture. Failure rates are high with this procedure and increase with repeated attempts.
Success rate after 1st OIU 30-40 % over 3 yrs
Success rate after 2nd OIU 15-20 % over 3 yrs
Success rate after 3rd OIU 0-10 % over 3 yrs