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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.
Circumcised
Circumcision is the surgical removal of the foreskin of the penis.
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
)
Cystoscopy
Cystoscopy is a surgical procedure. This is performed to see the inside of the bladder and urethra using a telescope.
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Severe, long-term
atrophic vaginitis
Atrophic vaginitis
Vaginal dryness is present when the tissues of the vagina are no longer well-lubricated and healthy.
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Symptoms
Symptoms include:
- Abnormal strength and direction of urine stream
- Bed wetting
-
Bleeding (
hematuria
) at end of urination
Hematuria
Blood in your urine is called hematuria. The amount may be very small and only detected with urine tests or under a microscope. In other cases, the...
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Discomfort with urination
or straining with urination
Discomfort with urination
Painful urination is any pain, discomfort, or burning sensation when passing urine.
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Incontinence
(day or night)
Incontinence
Urinary (or bladder) incontinence happens when you are not able to keep urine from leaking out of your urethra. The urethra is the tube that carries...
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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 .
Voiding cystourethrogram
A voiding cystourethrogram is an x-ray study of the bladder and urethra. It is done while the bladder is emptying.
Foley catheter
A urinary catheter is a tube placed in the body to drain and collect urine from the bladder.
Other tests may include:
-
Complete blood count (
CBC
)
CBC
A complete blood count (CBC) test measures the following:The number of red blood cells (RBC count)The number of white blood cells (WBC count)The tota...
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Kidney and bladder
ultrasound
Ultrasound
Ultrasound uses high-frequency sound waves to make images of organs and structures inside the body.
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Urine analysis
Urine analysis
Urinalysis is the physical, chemical, and microscopic examination of urine. It involves a number of tests to detect and measure various compounds th...
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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
Urinary tract infections
A urinary tract infection, or UTI, is an infection of the urinary tract. The infection can occur at different points in the urinary tract, including...
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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.
-
Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
-
Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
-
Meatal stenosis - illustration
Meatal stenosis results from irritation of the urethral opening at the end of the penis, which leads to tissue growth and scarring across the opening. The growth narrows the end of the penis causing the urine flow to become a fine narrow stream. Sometimes there is also bleeding at the end of urination. Meatal stenosis can usually be treated in the physician's office using local anesthesia to the area and dilating (widening) the urethral opening with special instruments.
Meatal stenosis
illustration
-
Female urinary tract - illustration
The female and male urinary tracts are relatively the same except for the length of the urethra.
Female urinary tract
illustration
-
Male urinary tract - illustration
The male and female urinary tracts are relatively the same except for the length of the urethra.
Male urinary tract
illustration
-
Meatal stenosis - illustration
Meatal stenosis results from irritation of the urethral opening at the end of the penis, which leads to tissue growth and scarring across the opening. The growth narrows the end of the penis causing the urine flow to become a fine narrow stream. Sometimes there is also bleeding at the end of urination. Meatal stenosis can usually be treated in the physician's office using local anesthesia to the area and dilating (widening) the urethral opening with special instruments.
Meatal stenosis
illustration
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.
