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Meatal Stenosis

Sometimes the opening of the penis where urine passes can become blocked and can cause various problems with urination. The following information should help you understand this condition and how it can be treated.

What is meatal stenosis?

Meatal stenosis is an abnormal narrowing of the urethral meatus in males. This refers to the size of the opening at the tip of the penis. This condition is usually acquired but can exist from birth.

What are some risk factors for meatal stenosis?

Meatal stenosis is most commonly associated with circumcision and is rarely seen in uncircumcised males. It is likely that the newly exposed tip of the penis (including the meatus) suffers mild injury as it rubs against a diaper or the child's own skin. Over time this chronic irritation can result in scarring and a narrowing of the meatus. It can also result from mild ischemia that occurs with circumcision. Meatal stenosis can also occur after hypospadias repair. While this is uncommon, it can present in up to 4% of patients undergoing surgery to correct hypospadias. Injury to the tip of the penis, inflammatory skin conditions (including balanitis and BXO), or prolonged use of urinary catheters can also increase the risk of meatal stenosis.

What are symptoms of meatal stenosis?

Meatal stenosis can present with many different symptoms related to a partially obstructed urinary stream. These include pain or burning with urination, urgency of urination, frequency of urination, as well as a urinary stream that sprays or is difficult to aim, or a small drop of blood from the meatus at the time of completion of urination.

How is meatal stenosis diagnosed?

Physical exam will reveal a small, narrowed meatus. This should correlate with urinating symptoms of urinary obstruction. Upon close inspection, the lower surface of the meatus is often adhered. Measuring the meatus is often unnecessary and will expose the patient to further risk of injury.

How is meatal stenosis treated?

Surgical intervention with a meatotomy, an incision to enlarge the meatus, is the most reliable treatment. This procedure involves sharply dividing the lower surface of the meatus. Recurrence of stenosis after meatotomy is rare, as long as appropriate care is provided by the parent. Dilation of the urethral meatus can result in tearing of the meatus. While this may provide short-term improvement in symptoms, the resultant scarring usually causes more severe symptoms and a narrower meatus.

What can be expected after treatment?

Meatotomy is a very effective treatment for meatal stenosis. Pain at the tip of the penis can be managed with oral analgesics or warm baths. Bleeding is rare and usually controlled with direct pressure. Recovery time is rapid, typically one to two days. Applying a lubricating ointment or petroleum jelly to the tip of the penis can aid in patient discomfort and wound healing.

Reviewed January 2011

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Meatal Stenosis Glossary
  • analgesic: A drug intended to alleviate pain.

  • balanitis: Inflammation of the head of the penis.

  • BXO: Also known as balanitis xerotica obliterans. Chronic skin condition that causes scarring and thickening of the skin of the penis.

  • catheter: A thin tube that is inserted through the urethra into the bladder to allow urine to drain or for performance of a procedure or test, such as insertion of a substance during a bladder X-ray.

  • chronic: Lasting a long time. Chronic diseases develop slowly. Chronic renal (kidney) failure may develop over many years and lead to end-stage renal (kidney) disease.

  • circumcise: To remove all or part of the foreskin from the penis.

  • circumcised: Removed all or part of the foreskin of the penis.

  • circumcision: The surgical removal of all or part of the skin covering the end of the penis, called the foreskin.

  • frequency: The need to urinate more often than is normal.

  • hypospadias: A birth defect in which the opening of the urethra, called the urinary meatus, is on the underside of the penis instead of at the tip.

  • incision: Surgical cut for entering the body to perform an operation.

  • inflammatory: Characterized or caused by swelling, redness, heat and/or pain produced in an area of the body as a result of irritation, injury or infection.

  • ions: Electrically charged atoms.

  • ischemia: Ischemia can also be described as an inadequate flow of blood to a part of the body, caused by constriction or blockage of the blood vessels supplying it.

  • meatal stenosis: Narrowing at the end of the urine channel at the tip of the penis.

  • meatotomy: Incision for the enlargement of the urethral opening at the tip of the penis.

  • meatus: The opening of the urethra.

  • obstruction: something that obstructs, blocks, or closes up with an obstacle

  • penis: The male organ used for urination and sex.

  • urethra: A tube that carries urine from the bladder to the outside of the body. In males, the urethra serves as the channel through which semen is ejaculated and it extends from the bladder to the tip of the penis. In females, the urethra is much shorter than in males.

  • urethral: Relating to the urethra, the tube tha carries urine from the bladder to outside the body.

  • urge: Strong desire to urinate.

  • urgency: Strong desire to urinate.

  • urinary: Relating to urine.

  • urination: The passing of urine.

  • urine: Liquid waste product filtered from the blood by the kidneys, stored in the bladder and expelled from the body through the urethra by the act of urinating (voiding). About 96 percent of which is water and the rest waste products.

  • urology: Branch of medicine concerned with the urinary tract in males and females and with the genital tract and reproductive system of males.

Meatal Stenosis Anatomical Drawings

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