Meatal stenosis is a narrowing of the opening of the urethra, the tube through which urine leaves the body.
Urethral meatal stenosis
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.
- Having many endoscopic procedures (cystoscopy)
- Severe, long-term atrophic vaginitis
- 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
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.
Most people will urinate normally after treatment.
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.
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.
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.