Urethral meatal stenosis

Alternative names
Meatal stenosis

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

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 (enuresis).

Symptoms

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

In boys, history and physical exam is adequate to make the diagnosis. In girls, VCUG (voiding cystourethrogram) is usually diagnostic. Other tests may include:

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

In females, meatal stenosis can usually be treated in the physician’s office 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 including abnormal stream, painful urination, frequent urination, urinary incontinence, blood in the urine, and increased susceptibility to urinary tract infections can be complications.

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 circumcized penis to irrititants.

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