The urethra is the tube that drains urine from the bladder. The end of the urethra on the tip of the penis is called the meatus. Meatal stenosis is the narrowing of the meatus. On exam the meatus appears nearly pin-point.
Boys with meatal stenosis typically have a urinary stream that deflects upward or is prolonged. It is often a challenge for them to stand to urinate. As they struggle to point their penis down toward the toilet, the urine deflects upwards. It’s similar to putting your finger over the end of a garden hose. Many choose to sit to urinate to make it easier.
It’s rare for these children to complain of pain with meatal stenosis, though the challenge of emptying the bladder could be a leading factor for dysuria (burning or pain with urination) or urinary tract infections.
If upon examination your child’s meatus appears narrow but your child has a normal urine stream and is not having any symptoms, treatment may not be necessary. Your child’s doctor will work with you to assess the severity of the condition and to determine if a surgical intervention is necessary.
The procedure for correcting meatal stenosis is called a meatotomy. It involves making a small slit to increase the size of the meatus. A meatotomy can usually be done in our office or sometimes in the operating room.
In the office setting, we apply a topical anesthetic cream. The cream is covered by a clear bandage and left in place for 45-60 minutes. With the help of toys, books or videos to distract your child, the meatotomy can safely and successfully be done. There are no stitches required.
If your child cannot sit still or there are other concerns, the meatotomy can be done in the operating room under a short general anesthesia. In this situation a few stitches will be left in place.
After the meatotomy we will ask that you instill an ointment, similar to Vaseline®, into the meatus. It’s important to keep this area lubricated as it heals.
Reviewed by: Division of Urology
Date: May 2011