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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) 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 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

 

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 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

Elder JS. Anomalies of the penis and urethra. In: Kliegman RM, Behrman RE, Jenson HB, Stanton BF, eds. Nelson Textbook of Pediatrics. 19th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 538.

Jordan GH, McCammon KA. Surgery of the penis and urethra. In: Wein AJ, ed. Campbell-Walsh Urology. 10th ed. Philadelphia, PA: Elsevier Saunders; 2011:chap 36.

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  • Female urinary tract

    Female urinary tract

    illustration

  • Male urinary tract

    Male urinary tract

    illustration

  • Meatal stenosis

    Meatal stenosis

    illustration

    • Female urinary tract

      Female urinary tract

      illustration

    • Male urinary tract

      Male urinary tract

      illustration

    • Meatal stenosis

      Meatal stenosis

      illustration

    A Closer Look

     

      Self Care

       

        Tests for Meatal stenosis

         
           

          Review Date: 1/21/2015

          Reviewed By: Scott Miller, MD, Urologist in private practice in Atlanta, GA. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.

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