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Meatal stenosis

Urethral meatal stenosis

Meatal stenosis is a narrowing of the opening of the urethra, the tube through which urine leaves the body.

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). In most cases, this problem occurs in newborns after circumcision. Abnormal scar tissue can grow across the opening of the urethra, causing it to narrow. The problem may not be detected until the child is toilet trained.

In adult men, the condition can result from surgery on the urethra, ongoing use of an indwelling catheter, or procedure to treat an enlarged prostate gland (BPH).

In females, this condition is present at birth (congenital). Less commonly, meatal stenosis may also affect adult women.

Risks include:

Symptoms

Symptoms include:

Exams and Tests

In men and 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:

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.

Marien T, Kadihasanoglu M, Miller NL. Complications of endoscopic procedures for benign prostatic hyperplasia. In: Taneja SS, Shah O, eds. Complications of Urologic Surgery. 5th ed. Philadelphia, PA: Elsevier; 2018:chap 26.

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.

Stephany HA, Ost MC. Urologic disorders. In: Zitelli BJ, McIntire SC, Nowalk AJ, eds. Zitelli and Davis' Atlas of Pediatric Diagnosis. 7th ed. Philadelphia, PA: Elsevier; 2018:chap 15.

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  • Female urinary tract - illustration

    The female and male urinary tracts are relatively the same except for the length of the urethra.

    Female urinary tract

    illustration

  • Male urinary tract - illustration

    The male and female urinary tracts are relatively the same except for the length of the urethra.

    Male urinary tract

    illustration

  • Meatal stenosis - illustration

    Meatal stenosis results from irritation of the urethral opening at the end of the penis, which leads to tissue growth and scarring across the opening. The growth narrows the end of the penis causing the urine flow to become a fine narrow stream. Sometimes there is also bleeding at the end of urination. Meatal stenosis can usually be treated in the physician's office using local anesthesia to the area and dilating (widening) the urethral opening with special instruments.

    Meatal stenosis

    illustration

  • Female urinary tract - illustration

    The female and male urinary tracts are relatively the same except for the length of the urethra.

    Female urinary tract

    illustration

  • Male urinary tract - illustration

    The male and female urinary tracts are relatively the same except for the length of the urethra.

    Male urinary tract

    illustration

  • Meatal stenosis - illustration

    Meatal stenosis results from irritation of the urethral opening at the end of the penis, which leads to tissue growth and scarring across the opening. The growth narrows the end of the penis causing the urine flow to become a fine narrow stream. Sometimes there is also bleeding at the end of urination. Meatal stenosis can usually be treated in the physician's office using local anesthesia to the area and dilating (widening) the urethral opening with special instruments.

    Meatal stenosis

    illustration

 

Review Date: 1/31/2019

Reviewed By: Sovrin M. Shah, MD, Assistant Professor, Department of Urology, The Icahn School of Medicine at Mount Sinai, New York, NY. 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.

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