DVIU · Direct Vision Internal Urethrotomy in Bangkok

DVIU is an excellent option for short, primary bulbar urethral strictures, typically under 1.5 cm, where there's no prior treatment history and minimal peri-urethral fibrosis. If your stricture is longer, has recurred previously, is located in the anterior urethra, or involves significant surrounding scar tissue, a urethroplasty generally offers a more durable and definitive solution. We will assess your specific stricture characteristics to determine if DVIU is suitable for you.

Recurrence after DVIU is a significant consideration, with rates ranging from 40-60% within 1-3 years. This variability depends on factors like your stricture's length, its exact location, and the number of prior treatments you've had. While a second DVIU can be considered, the success rates diminish significantly with each attempt. After one or two failed DVIUs, we typically recommend urethroplasty for a more lasting outcome.

Urethroplasty boasts a higher long-term success rate, often exceeding 85%, making it a very durable solution. However, it is an open surgical procedure requiring a longer recovery period, including a catheter for 2-3 weeks and a return to work in 2-3 weeks. DVIU is an endoscopic procedure with a much quicker recovery. The choice between DVIU and urethroplasty depends on your stricture's characteristics and your personal tolerance for potential repeat procedures versus a more extensive initial surgery.

Your recovery from DVIU is typically swift. You will have a catheter in place for 3-7 days. Most patients can resume light activities within a few days. For desk-based work, you can usually return within 5-7 days. Sexual activity can generally be resumed after your catheter is removed and the initial healing period is complete, usually within 1-2 weeks. We will provide detailed post-operative instructions tailored to your recovery.

The cost of your DVIU procedure in Bangkok will vary based on several factors. These include your chosen anesthesia type, whether you opt for a holmium laser for the incision, and the length of your hospital admission. We aim to provide transparent pricing. For a personalized quote tailored to your specific needs and treatment plan, we encourage you to book a consultation with our specialist.

While DVIU offers immediate relief, its long-term success rates are lower compared to urethroplasty. Initial success, meaning no recurrence within the first year, is seen in approximately 50-70% of cases. However, recurrence rates increase over time, reaching 40-60% within 1-3 years. The best long-term outcomes are typically observed in patients with very short, primary bulbar strictures. We will discuss your individual prognosis based on your specific stricture characteristics.

For your DVIU procedure, we offer a choice of anesthesia to ensure your comfort. You can opt for spinal anesthesia, which numbs the lower half of your body while you remain awake but sedated. Alternatively, general anesthesia will put you completely to sleep during the procedure. Your urologist and anesthesiologist will discuss the best option for you, considering your health status and personal preferences, to ensure a safe and comfortable experience.

During your consultation, you'll meet with our experienced urologist specializing in urethral stricture disease. We will review your medical history, perform a physical examination, and likely order diagnostic tests such as a uroflowmetry, post-void residual ultrasound, or even a retrograde urethrogram to precisely map your stricture. Based on these findings, we will discuss your treatment options, including DVIU, its pros and cons, and help you make an informed decision about your care.

As an international patient, we recommend arriving in Bangkok at least 1-2 days before your scheduled procedure for pre-operative assessments. You can typically fly home 7-10 days after your DVIU, once your catheter is removed and your urologist confirms you are stable. Post-operative follow-up can often be managed remotely via secure messaging platforms like WhatsApp, allowing you to recover comfortably at home while staying connected with our team.