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Direct Vision Internal Urethrotomy

  • Cynthia M. Johnson, MA
Publication Type:


Direct Vision Internal Urethrotomy

(DVIU; Endoscopic Internal Urethrotomy)


Direct vision internal urethrotomy (DVIU) is surgery to repair a narrow segment of the urethra. This is the tube that carries urine from the bladder to the outside of the body.

Reasons for Procedure

This surgery is done to treat urethral stricture. This is a narrowing of the urethra due to scar tissue.

Urethral stricture can result in:

  • Problems passing urine (pee)
  • Prostate problems in men
  • Bladder and kidney infections

DVIU cuts through the scar tissue and opens the urethra to lower the risk of these problems.

Male Urethra.

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Possible Complications

Problems are rare, but all procedures have some risk. The doctor will go over some problems that could happen, such as:

  • Excess bleeding
  • Problems from anesthesia, such as wheezing or sore throat
  • Infection
  • Blood clots
  • Pain when passing urine
  • Damage to the urethra
  • Urethral stricture that returns
  • The need for more surgery
  • Penile pain
  • Erectile dysfunction

Things that may raise the risk of problems are:

  • Smoking
  • Drinking excess alcohol
  • Chronic diseases, such as diabetes and obesity

What to Expect

Problems to Look Out For

Call the doctor if you are not getting better or you have:

  • Signs of infection, such as fever or chills
  • Pain that you cannot control with medicine
  • Problems passing urine
  • Problems using or caring for the catheter
  • Bloody urine that lasts more than a few days
  • New or worsening symptoms

If you think you have an emergency, call for medical help right away.

Prior to Procedure

Your doctor may do the following:

The surgical team may meet with you to talk about:

  • Anesthesia options
  • Any allergies you may have
  • Current medicines, herbs, and supplements that you take and whether you need to stop taking them before surgery
  • Fasting before surgery, such as avoiding food or drink after midnight the night before
  • Planning for a ride to and from surgery


The doctor may give:

  • A sedative—you will feel relaxed
  • Local anesthesia—the area will be numbed
  • General anesthesia —you will be asleep
  • Spinal anesthesia —you will be numb from the belly down

Description of the Procedure

A scope will be placed in the urethra to locate the narrowed segment. A tool will be passed through the scope and used to cut away the scar tissue inside the urethra to widen it. A tube called a catheter may be placed in the urethra to keep it open and allow urine to drain to the outside of the bladder. It will be removed at a later time when it is no longer needed.

How Long Will It Take?

About 30 minutes

Will It Hurt?

Anesthesia will prevent pain during surgery. Pain is common in the first few weeks. Medicine and home care can help.

Average Hospital Stay

Most people can go home the same day. If you have any problems, you may need to stay longer.

Post-procedure Care

At the Care Center

After the procedure, the staff may:

  • Give you pain medicine
  • Encourage you to walk to promote bloodflow
  • Check to make sure that you are passing urine
  • Teach you how to care for the catheter

At Home

It will take about 2 weeks to fully heal. Physical activity will be limited during this time. This includes sexual activity. You may need to delay your return to work.





  • Direct vision internal urethrotomy. Flint Urology website. Available at: http://www.flinturology.com/dvi_urethrotomy.shtml.
  • Direct visual internal urethrotomy (DVIU) home care. University of Wisconsin Hospitals and Clinics website. Available at: https://patient.uwhealth.org/healthfacts/4416?_ga=2.18954737.899656532.1663870886-285841435.1663870886.
  • Traumatic genitourinary tract injuries in adults. EBSCO DynaMed website. Available at: https://www.dynamed.com/condition/traumatic-genitourinary-tract-injuries-in-adults.


  • Mark S. Itzkowitz, MD, JD
Last Updated:

This content is reviewed regularly and is updated when new and relevant evidence is made available. This information is neither intended nor implied to be a substitute for professional medical advice. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with questions regarding a medical condition.