OIU (Optical Internal Urethrotomy)
Endoscopic incision of a urethral stricture under direct vision to re-establish urinary flow — day-case procedure, immediate relief, 70–80% success for short strictures in the urethra.
What is OIU (Optical Internal Urethrotomy)?
Optical Internal Urethrotomy (OIU) is an endoscopic procedure in which a cold knife or laser is used to incise a urethral stricture under direct vision, widening the urethral lumen and re-establishing urinary flow. A urethrotome is passed transurethrally to the stricture and incisions are made at the 12 o'clock position through scar tissue until the urethral lumen is fully opened. OIU is a first-line treatment for primary, short (under 1.5 cm) bulbar urethral strictures. Recurrence rates are 30% at 12 months, particularly for longer strictures, and repeated OIU provides progressively diminishing benefit over time.
How the Procedure Works
Urethrotome Insertion
Urethrotome introduced transurethrally; urethra inspected; stricture identified, measured, and its extent assessed before incision begins.
Stricture Incision
Cold knife or holmium laser used to incise the stricture at the 12 o'clock position through the full depth of scar tissue until normal urethra is reached.
Lumen Assessment
Urethrotome or cystoscope advanced through the opened stricture to confirm adequate luminal calibre and assess for distal stricture involvement.
Catheter Placement
16–18 Fr urethral catheter placed through the opened stricture site; remains for 24–48 hours.
Discharge
Most patients discharged same day; urine flow confirmed improving before discharge; follow-up flow rate at 6–8 weeks assesses durability of result.
Outcomes
Who Needs This Treatment?
- →Men with a short primary bulbar urethral stricture under 1.5 cm causing significant urinary retention or obstruction.
- →Those who have not previously undergone any urethral treatment and present with a first stricture episode.
- →Patients unsuitable for or declining urethroplasty as initial management who accept higher recurrence risk.
- →Those who wish to avoid open surgery as first-line treatment and accept post-operative CISD to reduce recurrence.
- →Men with recurrent retention where a quick day-case procedure is required before planning definitive urethroplasty.
- →Patients with multiple comorbidities where the shorter anaesthetic time of OIU is preferable to open urethroplasty.
"OIU is an excellent first-line option for short primary urethral strictures. However, for recurrent or longer strictures, we counsel patients early about urethroplasty — which offers far more durable cure rates than repeated endoscopic incisions."
— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon
Common Questions
Frequently Asked
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