Scrotal oedema: a misadventure of direct vision internal urethrotomy

Description 

A 30-year-old man presented with voiding lower urinary tract symptoms for 2 years due to bulbar urethral stricture. He had a history of appendectomy two and a half years ago during which he was catheterised. His retrograde urethrogram was suggestive of a short (<1 cm) bulbar urethral stricture (figure 1). After proper counselling, he was posted for direct vision internal urethrotomy (DVIU) under spinal anaesthesia. Immediately following the procedure, he developed scrotal oedema (figure 2). Perineal compression was given along with scrotal support. The patient was observed for 2 days in the ward; there was no increase in the oedema. He was subsequently discharged with an advice to keep a scrotal support and called on the 10th postoperative day. His oedema had completely resolved and his catheter was removed. He voided with a good flow rate of 27 mL/s and had a normal bell-shaped curve on uroflow...

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