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, incidence, and risk factors

Meatal stenosis can affect both males and females, but it is more common in males. In males, it is often caused by inflammation following the circumcision of a newborn. This leads to abnormal tissue growth and scarring across the urethral opening. The problem is usually not detected until the child is toilet trained.

In females, this condition is a congenital (present from birth) abnormality which can cause urinary tract infections and bed-wetting. Although less common, this condition may also be seen in adult women. It may occur if multiple endoscopic procedures (cystoscopy) have been performed, or if the person suffers from severe, long-term atrophic vaginitis.

Symptoms

• Abnormal strength and direction of urinary stream
• Visible narrow opening in boys
• Discomfort with urination
• Incontinence (day or night)
• Bleeding (hematuria) at end of urination
• Urinary tract infections

Signs and tests

In boys, history and physical exam is adequate to make the diagnosis. In girls, VCUG (voiding cystourethrogram) is usually diagnostic. The narrowing may also be found on physical exam, or at the time of attempted Foley catheter placement.

Other tests may include:

• Urine analysis
• Urine culture
• CBC, basic metabolic panel
• Renal and bladder ultrasound

Treatment

In females, meatal stenosis can usually be treated in the physician's office. This is done using local anesthesia to numb the area and dilating (widening) the urethral opening with special instruments. In boys, meatoplasty, a minor outpatient surgical procedure, is the treatment of choice.

Expectations (prognosis)

Most people can expect normal urination after treatment.

Complications

Persistent urinary problems can be complications resulting from meatal stenosis. They include:

• Abnormal urine stream
• Painful urination
• Frequent urination
• Urinary incontinence
• Blood in the urine
• Increased susceptibility to urinary tract infections

Calling your health care provider

Call for an appointment with your health care provider if your child has symptoms of this disorder.

Prevention

In a recently circumcised male infant, try to maintain a clean, dry diaper and avoid any exposure of the newly circumcised penis to irritants.