Meatal stenosis
Definition
Meatal stenosis is a narrowing of the opening of the urethra, the tube through which urine leaves the body.
Alternative Names
Urethral meatal stenosis
Causes
Meatal stenosis can affect both males and females. It is more common in males.
In males, it is often caused by swelling and irritation (inflammation) after a newborn is circumcised. This leads to abnormal tissue growth and scarring across the opening of the urethra. In most cases, the problem is not found until the child is toilet trained. Surgery on the urethra, chronic catheterization, or other medical instruments in the urethra may also lead to meatal stenosis.
In females, this condition is present at birth (congenital). Less commonly, meatal stenosis may also affect adult women.
Risks include:
- Having many endoscopic procedures (cystoscopy)
- Severe, long-term atrophic vaginitis
Symptoms
Symptoms include:
- Abnormal strength and direction of urine stream
- Bed wetting
- Bleeding (hematuria) at end of urination
- Discomfort with urination or straining with urination
- Incontinence (day or night)
- Visible narrow opening in boys
Exams and Tests
In boys, a history and physical exam are enough to make the diagnosis.
In girls, a voiding cystourethrogram may be done. The narrowing may also be found during a physical exam, or when a health care provider tries to place a Foley catheter.
Other tests may include:
- Complete blood count (CBC)
- Kidney and bladder ultrasound
- Urine analysis
- Urine culture
Treatment
In females, meatal stenosis is most often treated in the provider's office. This is done using local anesthesia to numb the area. Then the opening of the urethra is widened (dilated) with special instruments.
In boys, a minor outpatient surgery called meatoplasty is the treatment of choice. Dilation of the meatus may also be appropriate in some cases.
Outlook (Prognosis)
Most people will urinate normally after treatment.
Possible Complications
Complications may include:
- Abnormal urine stream
- Blood in the urine
- Frequent urination
- Painful urination
- Urinary incontinence
- Urinary tract infections
- Damage to bladder or kidney function in severe cases
When to Contact a Medical Professional
Call your provider if your child has symptoms of this disorder.
Prevention
If your baby boy has recently been circumcised, try to keep the diaper clean and dry. Avoid exposing the newly circumcised penis to any irritants. They may cause inflammation and narrowing of the opening.
References
Elder JS. Anomalies of the penis and urethra. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier; 2016:chap 544.
McCammon KA, Zuckerman JM, Jordan GH. Surgery of the penis and urethra. In: Wein AJ, Kavoussi LR, Partin AW, Peters CA, eds. Campbell-Walsh Urology. 11th ed. Philadelphia, PA: Elsevier; 2016:chap 40.
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Review Date:
1/30/2017 Reviewed By: Jennifer Sobol, DO, urologist with the Michigan Institute of Urology, West Bloomfield, MI. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. |
