Meatal stenosis

Urethral meatal stenosis is a narrowing (stenosis) of the opening of the urethra, the tube through which urine leaves the body from the urinary bladder.

Causes, incidence, and risk factors

Meatal stenosis can affect both males and females, but it is more common in males. In males, it is often caused by inflammation following the circumcision of a newborn. This leads to abnormal tissue growth and scarring across the urethral opening. The problem is usually not detected until the child is toilet trained.

In females, this condition is a congenital (present from birth) abnormality which can cause urinary tract infections and bed-wetting (enuresis).

Symptoms

• Abnormal strength and direction of urinary stream
• Visible narrow opening at the meatus in boys
• Discomfort with urination (dysuria and frequency)
• Incontinence (day or night)
• Bleeding (hematuria) at end of urination
• Urinary tract infections

Signs and tests

In boys, history and physical exam is adequate to make the diagnosis. In girls, VCUG (voiding cystourethrogram ) is usually diagnostic. Other tests may include:

• Urine analysis
• Urine culture
• CBC, basic metabolic panel
• Renal and bladder ultrasound

Treatment

In females, meatal stenosis can usually be treated in the physician's office using local anesthesia to numb the area and dilating (widening) the urethral opening with special instruments. In boys, meatoplasty , a minor outpatient surgical procedure, is the treatment of choice.

Prognosis

Most people can expect normal urination after treatment.

Complications

Persistent urinary problems including abnormal stream, painful urination, frequent urination, urinary incontinence, blood in the urine, and increased susceptibility to urinary tract infections can be complications.

Prevention

In a recently circumcised male infant, try to maintain a clean, dry diaper and avoid any exposure of the newly circumcized penis to irrititants.

Source

• Meatal stenosis. MedlinePlus Medical Encyclopedia. Public domain text.