|
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, but 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. The problem is usually not found until the child is toilet trained.
In females, this condition is present at birth (congenital). Although less common, metal stenosis may also affect adult women.
Risks include:
- Having multiple endoscopic procedures (cystoscopy)
- Severe, long-term atrophic vaginitis
Symptoms
- 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 can usually be treated in the health care 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.
Outlook (Prognosis)
Most people will urinate normally after treatment.
Possible Complications
- Abnormal urine stream
- Blood in the urine
- Frequent urination
- Painful urination
- Urinary incontinence
- Urinary tract infections
When to Contact a Medical Professional
Call for an appointment with your health care 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
Jordan GH, McCammon KA. Surgery of the penis and urethra. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 36.
Elder JS. Anomalies of the penis and urethra. In: KliegmanRM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, Pa: Saunders Elsevier; 2011:chap 538.
Reviewed By: Linda J. Vorvick, MD, Medical Director and Director of Didactic Curriculum, MEDEX Northwest Division of Physician Assistant Studies, Department of Family Medicine, UW Medicine, School of Medicine, University of Washington. Louis S. Liou, MD, PhD, Chief of Urology, Cambridge Health Alliance, Visiting Assistant Professor of Surgery, Harvard Medical School. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.
