Dilation of the urethra is a procedure used in treatment of an urethral stricture, the condition marked by narrowing of the urethral tube. Methods of Urethral Dilation
Urethral dilation can be done in a doctor’s office under local or general anesthesia. The procedure is performed to stretch or dilate the urethra with the help of progressively larger dilators. Urethral stricture can occur at any section of the urethral tube. If the urethral stricture is located toward the tip of the penis, it is widened with metal rods of increasing thickness. These rods are known as urethral sounds. Van Buren urethral sounds are most commonly used for the procedure.
Another method of dilation of the urethra involves the use of a long, narrow instrument called the filiform which is passed through the urethra. Then dilators called followers of progressively larger diameter are attached to the filiform to widen the stricture.
Another option involves balloon dilating of the urethral stricture. In this procedure an urologist uses a flexible tip guide wire to pass it through the stricture. This instrument is then used to introduce a balloon dilating catheter to the location of the stricture. The balloon catheter is then slowly inflated. Once it is deflated, both the catheter and guide wire are taken out. Alternatively, a temporary stenting catheter can be introduced over the guide wire. Internal Urethrotomy (DVIU)
Internal urethrotomy is also known as optical urethrotomy, visual urethrotomy or direct vision internal urethrotomy (DVIU).This is a more invasive procedure, performed in an operating room under general anesthesia. Internal urethrotomy involves use of a thin telescope or endoscopic instrument to detect location of the stricture. The telescope is inserted into the urethra and then, a small blade is advanced over the instrument to cut along the stricture. The cut can be made in one or more places to widen the urethral stricture. Next, an urethral stent can be placed for 3 to 5 days to keep the urethra open while the wound heals. However, this most commonly results in formation of scar tissue which leads to recurrent stricture. Then the procedure may have to be repeated.
In this procedure, an internal metallic stent is placed into the urethra endoscopically. This stent is used to permanently widen the urethra. Although, this technique is simple to perform, there is a high risk of failure and complications because urethral strictures usually form within or adjacent to the stent.