Meatal Stenosis

Meatal stenosis is an abnormal narrowing of the urethral opening (meatus). If the narrowing becomes significant, urine will have difficulty flowing from the bladder and may cause the bladder to not empty completely. If left untreated, this can lead to urinary tract infections and kidney problems.

Meatal stenosis is a common complication of circumcision, caused from chronic exposure of the irritating effects of urine on the meatus and rubbing of the meatus on a diaper or clothing.

Children may have difficulty urinating. They may have urinary frequency, prolonged urination, a thin stream, difficulty starting urinary flow, keeping the flow going, difficulty in aiming the stream into the toilet, spraying of the urinary stream, and straining or arching of the back during voiding. Some children may have microscopic blood in the urine or painful urination.

Treatment of this condition is by surgery, called a meatoplasty. The meatus is opened or widened by making an incision below the meatus. This can be done in the operating room under general anesthesia. It may also be done using a local anesthetic in the office.

If done in the operating room, it involves making an incision in the urethral opening and placing 3 dissolvable sutures around the meatus. If done in the office, the surgeon makes a small incision into the meatus, but does not place any sutures.

If the narrowed opening is not fixed, it can become increasingly difficult to urinate, cause urinary tract infections, and swollen kidneys.

After the meatoplasty, triple antibiotic ointment should be applied to the sutures (if present) every 2 hours while awake. You may also be asked to do meatal care by inserting a dab of ointment into the opening several times a day.

Encourage a large fluid intake to help reduce stinging. The less concentrated the urine, the less stinging. Fluids to avoid are citrus juices and soda pop.

Your child may experience stinging with urination for the first 24 hours. Generally he or she can resume school the next day unless very uncomfortable.

Call your doctor if your child is unable to urinate or if the stream is thin or split after surgery.

Last Updated 04/2015