Urology · London
Urethral dilation - private in London.
Day-case treatment of urethral stricture - filiform and follower dilation, balloon dilation, Otis or Sachse internal urethrotomy, or the Optilume paclitaxel-coated balloon - by a consultant urologist with a subspecialty interest in urethral reconstruction.
Why patients choose us
- 01
A named urethral-stricture urologist, not a general list
A consultant urologist with a high stricture case volume, in a unit with retrograde urethrogram, flexible cystoscopy and urethroplasty pathways in-house.
- 02
The right technique for the stricture
Dilation and internal urethrotomy are first-line for short simple strictures. For recurrent or long strictures we refer for buccal-mucosa urethroplasty - the gold-standard cure - before you commit to a repeat dilation.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private urethral dilation costs in London.
Indicative ranges across our London partner units. Send the flow and RUG and we quote firm figures across two or three options within one working day.
In short
A urethral dilation in our London network: £2,400 to £4,500 all-inclusive, home the same day.
| Procedure | Indicative range | Typical duration | Turnaround |
|---|---|---|---|
| Diagnostic assessment (flow, PVR, flexible cystoscopy) | £650–£1,400 | 30–45 min | Same visit |
| Retrograde urethrogram (RUG) | £450–£950 | 20–30 min | Same visit |
| Urethral dilation (bougies or balloon) | £2,400–£4,500 | 20–40 min | Same day |
| Direct visual internal urethrotomy (DVIU) | £3,500–£5,500 | 30–60 min | Same day / overnight |
| Optilume paclitaxel-coated balloon dilation | £6,500–£10,000 | 45–60 min | Same day / overnight |
| Buccal-mucosa urethroplasty (referral) | £14,000–£22,000 | 2–4 hours | 1–2 night stay |
Prices vary by unit, by which consultant does the case, by anaesthetic type, and by stricture length and location. Optilume adds the cost of the drug-coated balloon consumable. We quote firmly within one working day.
The problem
Widening a narrowed urethra, without setting up the next recurrence.
Urethral stricture is a scar in the lining of the urethra that narrows the channel and slows the stream. Dilation and internal urethrotomy are quick, day-case first-line options. The trap is going back for a second, third or fourth dilation when Optilume or urethroplasty would be the durable answer.
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Is dilation the right first step?
For a short, simple bulbar stricture, yes. For long, dense, BXO-related or recurrent strictures, urethroplasty or Optilume should be discussed upfront.
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Have you had this done before?
If you have had one or two dilations already, another one has a very low chance of durable success - the honest conversation is Optilume or urethroplasty.
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Want it done in a specialist unit?
A named consultant urologist with a subspecialty interest in reconstruction, in a London unit with RUG, cystoscopy and urethroplasty pathways in-house.
The journey
From referral to catheter out - what happens, in order.
One team from first message to your first surveillance flow - including the catheter removal and the honest conversation about what to do if the stricture comes back.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the unit
Phase 3 · After
Concierge, back on
- 01
Before
You send us the flow chart and scope report
A short, confidential form. Your uroflowmetry, post-void residual, retrograde urethrogram (RUG) and prior cystoscopy notes if you have them.
- 02
Before
We come back with a recommendation
Within one working day: whether dilation, internal urethrotomy, an Optilume drug-coated balloon, or urethroplasty is the right call. Indicative price. An honest read either way.
- 03
Before
We arrange the procedure
Usually within one to two weeks. Antiplatelets and anticoagulants reviewed with the team, and clear pre-op instructions sent.
- 04
On the day
Arrival at the unit
Arrival, consent and a chat with the urologist and anaesthetist. Local plus sedation for a simple dilation, general anaesthetic for internal urethrotomy or Optilume.
- 05
On the day
The procedure itself
20 to 60 minutes. Cystoscopy through the stricture, then filiform and follower catheters, graduated bougies, a balloon dilator, or an Otis or Sachse urethrotome. Optilume adds a paclitaxel-coated balloon.
- 06
On the day
Home the same day, or overnight
A short recovery, catheter in situ, written aftercare, and home the same day for dilation or the morning after for internal urethrotomy.
- 07
After
Catheter out and surveillance
Catheter removed at 3 to 5 days. Uroflowmetry and post-void residual at 6 weeks, then every 3 to 6 months to catch recurrence early.
Typical end-to-end: 1 to 2 weeks to procedure. Catheter out: 3 to 5 days. First surveillance flow: 6 weeks.
When it helps
When dilation is the right step - and when it is not.
The stricture patterns we see most, plus the situations where dilation is abandoned in favour of Optilume or a buccal-mucosa urethroplasty.
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Weak or splitting urinary stream
A slow, deviated or spraying stream, straining to start, or a sense of incomplete emptying - the classic pattern for a bulbar or penile-urethral stricture.
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Recurrent urinary tract infection
A stricture that leaves a raised post-void residual can seed recurrent UTIs - dilation plus antibiotic cover often breaks the cycle.
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Stricture after prior instrumentation
A narrowing that follows catheterisation, TURP, ureteroscopy or cystoscopy - one of the most common iatrogenic causes we see.
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Post-traumatic stricture (straddle injury)
A bulbar-urethral narrowing after a straddle injury, pelvic fracture or perineal trauma - often better treated with urethroplasty than repeat dilation.
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Recurrent stricture after prior dilation
A stricture that returns within 12 months of dilation or DVIU - the point at which Optilume or urethroplasty should be discussed rather than another dilation.
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Lichen sclerosus / BXO penile stricture
A long penile-urethral stricture from balanitis xerotica obliterans (BXO) - dilation rarely durable, staged urethroplasty is usually the right answer.
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Female urethral stricture (rare)
Persistent hesitancy, obstructive voiding and raised residual in a woman - a rare diagnosis that needs specialist workup before dilation.
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Red flag: acute retention
Sudden inability to pass urine, severe suprapubic pain, or fever with a known stricture - go to A&E for catheterisation the same day.
Procedure options
Dilation, urethrotomy, Optilume, urethroplasty - the whole ladder.
What each option on the table actually involves - and which fits which stricture. The ROBUST III trial showed Optilume gave 75 per cent freedom from repeat intervention at 12 months, versus 27 per cent with standard dilation.
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Filiform and follower dilation
A fine filiform is passed through the stricture, then progressively larger followers are threaded over it - the gentlest option for tight, tortuous strictures.
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Graduated bougie dilation
Metal or plastic sounds of increasing calibre are passed under vision - quick and effective for short, straight bulbar strictures.
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Balloon dilation
A high-pressure balloon is positioned across the stricture and inflated - a controlled radial force that some evidence suggests causes less shear trauma than bougies.
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Direct visual internal urethrotomy
A Sachse cold knife or Otis urethrotome makes a 12-o'clock incision through the scar under cystoscopic vision - a full-thickness cut rather than a stretch.
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Optilume drug-coated balloon
Standard dilation followed by a paclitaxel-coated balloon - the drug inhibits fibroblast proliferation and cuts recurrence. Approved for recurrent anterior urethral stricture.
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Clean intermittent self-dilation
A programme of self-passed catheters after dilation to keep the urethra patent - reduces recurrence but is a long-term commitment.
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Buccal-mucosa urethroplasty
Open reconstruction with a graft of cheek lining - the gold-standard, durable cure for recurrent or long strictures. Longer procedure, longer recovery, best long-term outcome.
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Second-opinion review
A specialist review of your flow, RUG and cystoscopy report - sometimes the answer is watchful waiting, sometimes it is straight to urethroplasty rather than another dilation.
Our vetted London network
A small panel of consultant urologists, we picked them.
We work with named urethral-reconstruction consultants at University College London Hospital Private Urology, HCA The Wellington Urology, Cromwell Hospital, King's College Hospital Private, The London Clinic and Guy's and St Thomas' Private.
Selection criteria
How we choose every urologist in our London network.
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Consultant urologists with a subspecialty interest in urethral reconstruction
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Units with in-house RUG, flexible cystoscopy and urodynamics
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Optilume drug-coated balloon and buccal-mucosa urethroplasty pathways available
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Anaesthetist-delivered sedation or GA depending on stricture complexity
Safety, recovery and outcomes
What to expect afterwards - honestly.
Standard dilation and DVIU are durable at 5 years in only 30 to 40 per cent of patients. Optilume achieves around 75 per cent freedom from repeat intervention at 12 months. Buccal-mucosa urethroplasty gives 85 to 95 per cent durable success at 5 to 10 years.
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Local anaesthetic or general anaesthetic
A simple dilation is usually local plus sedation. Internal urethrotomy and Optilume are typically done under a short general anaesthetic for comfort and safety.
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Catheter for 3 to 5 days
A urethral catheter stays in for 3 to 5 days after dilation or DVIU, and often up to 7 days after Optilume, to let the mucosa heal without re-scarring across the segment.
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Dysuria and mild haematuria
Burning on passing urine and pink or lightly bloodstained urine for 1 to 2 weeks is normal. Increase fluids, and paracetamol is usually enough.
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Urinary tract infection
A short course of antibiotics is given around the procedure. Fever, rigors or cloudy foul-smelling urine after the catheter is out needs a same-day GP or urology review.
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Recurrence is common
Standard dilation and DVIU have a durable success at 5 years of only 30 to 40 per cent. Recurrence within 12 months is the trigger to discuss Optilume or urethroplasty.
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Rare: false passage or perforation
A false passage in the urethral wall is rare but possible - usually managed with a longer indwelling catheter. Perforation is very rare and settles conservatively.
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Erectile function
A dilation or internal urethrotomy does not usually affect erections. Urethroplasty carries a small risk of temporary erectile dysfunction that mostly recovers by 6 months.
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Return to work in 2 to 3 days
Office work in 2 to 3 days once the catheter is out. Heavy lifting, cycling and gym in 2 weeks. No sex until the catheter is out and dysuria has settled.
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Red flags after discharge
Inability to pass urine after the catheter is out, heavy fresh bleeding, fever above 38C or worsening perineal pain - call the unit or go to A&E the same day.
Reading your urology report
Your dilation report in four parts. Read the last one first.
Whichever technique was used, the report the urologist sends you keeps to the same shape.
A quiet reminder
Urology language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the report before your review, just ask.
- 01 Header
Stricture site, length and calibre
Where the narrowing is (bulbar, penile, membranous, meatal), its length in centimetres, and the smallest calibre passed in French gauge.
- 02 Technique
Dilation, DVIU or Optilume
Which technique was used, the final calibre reached, and whether a paclitaxel-coated Optilume balloon was deployed after the standard dilation.
- 03 Findings
Any false passage, bleeding, catheter
Whether a false passage was seen, intra-procedure bleeding, and the size and duration of the indwelling catheter.
- 04 Impression
Surveillance and self-dilation plan
Read this first: catheter removal date, whether a clean intermittent self-dilation programme is recommended, and the interval to your first uroflowmetry check.
Recognised by major UK insurers
Cover for urethral dilation varies by insurer and by indication - usually funded when medically indicated. Optilume cover is newer and checked case by case. We confirm cover before booking.
Frequently asked
Everything we get asked about urethral dilation.
Quick answers on recurrence, Optilume, insurance, paediatric care, recovery, and going home with a catheter.
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Will my urethral stricture come back after dilation?
Standard dilation and internal urethrotomy have a 5-year durable success of only around 30 to 40 per cent - most strictures do recur, often within 12 months. That is why a clear surveillance plan matters, and why we discuss Optilume or urethroplasty upfront if you have already had one or two dilations.
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Optilume versus urethroplasty - which is better for me?
The Optilume drug-coated balloon delivers paclitaxel to the stricture to inhibit scarring. The ROBUST III trial showed around 75 per cent of men were free from repeat intervention at 12 months, versus 27 per cent with standard dilation. Urethroplasty (buccal-mucosa graft) has an 85 to 95 per cent durable success at 5 to 10 years and is the gold-standard cure for recurrent or long strictures - but it is a bigger operation with a longer recovery. We help you weigh the trade-off.
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Will my insurance cover urethral dilation?
Most UK insurers (Bupa, AXA, Vitality, Aviva, WPA, Cigna, Healix) fund urethral dilation and internal urethrotomy when medically indicated. Optilume is newer and cover varies - we check with your insurer before booking. Self-pay is straightforward and quoted firmly within one working day.
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Can urethral dilation be done in children?
Paediatric urethral stricture is uncommon and needs a specialist paediatric urology unit rather than an adult private list. If your child has a stricture, we can point you to NHS or private paediatric centres with the right expertise.
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How long is the recovery after urethral dilation?
Home the same day for a simple dilation, or the morning after for internal urethrotomy or Optilume. Catheter out at 3 to 5 days. Mild burning and pink urine for 1 to 2 weeks. Office work in 2 to 3 days. Cycling, gym and heavy lifting in 2 weeks. No sex until the catheter is out and dysuria has settled.
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Do I have to go home with a catheter?
Yes, almost always. A urethral catheter stays in for 3 to 5 days after dilation or DVIU and up to 7 days after Optilume, to let the mucosa heal without re-scarring across the treated segment. It is removed at the clinic or by a district nurse. Written care instructions and a 24/7 contact are provided.
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Ready to talk?
Send us your flow chart and RUG. We come back within one working day.
An impartial, consultant-led recommendation across dilation, internal urethrotomy, Optilume and urethroplasty - with firm prices across two or three London units.