Visual Internal Urethrotomy (VIU) is a procedure used to treat urethral strictures, which are narrowings or blockages in the urethra, the tube that carries urine from the bladder out of the body. Here's an overview of VIU:
Indications for VIU
Urethral Strictures: Narrowing of the urethra due to scar tissue formation, often caused by trauma, infection, or previous surgical procedures.
Symptoms: Difficulty urinating, weak urinary stream, urinary retention, or recurrent urinary tract infections (UTIs) due to incomplete bladder emptying.
Procedure Overview
1. Preoperative Preparation
Patients may be instructed to fast for several hours before the procedure.
Preoperative evaluation includes urine tests, imaging studies (such as urethrography or cystoscopy), and assessment of urethral stricture length and location.
2. Anesthesia
VIU is typically performed under local or general anesthesia, depending on patient and surgeon preference.
3. Procedure Steps
Insertion of Cystoscope: The patient is usually positioned on their back. A cystoscope (a thin tube with a light and camera) is inserted through the urethra into the area of the stricture.
Visualization: The surgeon uses the cystoscope to visualize the narrowed segment of the urethra and assess the extent and severity of the stricture.
Incision (Internal Urethrotomy): A small incision is made in the scar tissue to widen the urethral opening, allowing urine to pass more freely.
Dilation: A balloon or other dilating device may be used to stretch the narrowed area of the urethra, improving urine flow.
Bladder Irrigation: Saline solution may be used to wash out debris and blood from the urethra.
Advantages of VIU
Minimally Invasive: No external incisions are made, resulting in faster recovery compared to open surgery.
Effective: Provides temporary relief of symptoms by widening the narrowed urethra.
Short Procedure Time: Typically performed as a day procedure, minimizing hospital stay and recovery time.
Visual Internal Urethrotomy (VIU) is a valuable minimally invasive procedure for treating urethral strictures, providing temporary relief of symptoms and improving urinary flow. However, recurrence of strictures is common, and ongoing monitoring and potential repeat procedures may be necessary to maintain urethral patency and relieve symptoms effectively.
