Meatal stenosis is an abnormal narrowing of the urethral opening (meatus). If the narrowing becomes significant, urine will trouble flowing from the bladder and may cause the bladder to not empty completely. If left untreated, this can lead to urinary tract infections and kidney problems.

Meatal stenosis is a common complication of circumcision, caused from chronic exposure of the irritating effects of urine on the meatus and rubbing of the meatus on a diaper or clothing.

Signs and Symptoms of Meatal Stenosis

Children may have the following symptoms:

• Trouble urinating
• Urinate often
• Prolonged urination a thin stream of urine
• Trouble starting and keeping the flow of urine going trouble aiming the stream into the toilet
• Urine sprays instead of single stream
• Straining or arching of the back when urinating

Some children may have microscopic blood in the urine or pain with urination.

Treatment of Meatal Stenosis

This condition is treated with surgery, called a meatoplasty. An incision is made below the meatus to open it or make it wider. Surgery is performed in the operating room under general anesthesia but may also be done using a local anesthetic in the office.

If done in the operating room, an incision is made in the meatus and dissolvable sutures are placed around the meatus. If done in the office, a small incision is made in the meatus, but does not place any sutures.

If the narrowed opening is not fixed, it can harder to urinate, and cause urinary tract infections, and swollen kidneys.

After Surgery

After the meatoplasty, apply triple antibiotic ointment to the sutures (if present) every two hours while awake. You may also need to do meatal care inserting a dab of ointment into the opening several times a day.

Encourage your child to drink every few hours throughout the day will help reduce stinging. The less concentrated the urine, the less stinging. Avoid citrus juices and soda pop.

Your child may have stinging with urination for the first 24 hours. Generally they can resume school the next day unless very uncomfortable.

Call your doctor if your child is unable to urinate or if the stream is thin or split after surgery.