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meatal stenosis

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Male genitourinary system

Alternative Names
urethral meatal stenosis

Meatal stenosis is a narrowing of the meatus, which restricts the flow of urine. The urethra is the narrow tube that carries urine from the bladder to the outside. In males, the urethra ends at the tip of the penis. The opening to the outside is known as the meatus. The condition is seen mostly in young boys, but sometimes occurs in adult men.

What is going on in the body?
A child may be born with meatal stenosis, especially if there are other abnormalities of the genitals. Meatal stenosis is most often caused when newborn boys are circumcised.

In adult men, meatal stenosis usually follows infection or trauma to the urethra. It can also be caused by some inflammatory conditions.

What are the signs and symptoms of the condition?
If a boy has no other abnormalities of the genitals, meatal stenosis is not usually noticed until the child is toilet trained. The urinary stream is narrow, and may be quite forceful and deflected in one direction or another. The urethral meatus does not open completely with voiding. There may be painful or frequent urination. Blood may appear in the urine, but this is more likely to be caused by an infection than the stenosis itself. Adults with meatal stenosis have the same symptoms.

What are the causes and risks of the condition?
The condition is more likely to occur in boys born with other abnormalities of the penis and urethra, such as hypospadias. Many cases in children are thought to be a result of circumcision as newborns.

In adult men, the condition can be caused by sexually transmitted diseases of the urethra or trauma.

How is the condition diagnosed?
Stenosis of the meatus can usually be seen fairly easily. The severity of the stenosis can be measured. Ultrasound tests may be done to make sure the bladder and kidneys are not blocked. Other tests may be done if there is a history of urinary tract infections.

What are the long-term effects of the condition?
Meatal stenosis rarely leads to any long-term complications.

What are the treatments for the condition?
In children, the condition is usually easily treated with a small incision in the meatus. In some cases, the outside skin may then be sewn to the inside lining of the urethra.

Both procedures can usually be done in the doctor's office. In adults with more severe urethral meatal stenosis, a slightly more complex surgical procedure can be done.

What are the side effects of the treatments?
For a week or so after any of the surgical treatments, the meatus should be gently opened with a small plastic dilator 1 to 3 times a day. This may be uncomfortable. Surgery carries a risk of bleeding, infection, and allergic reaction to anaesthesia.

What happens after treatment for the condition?
After treatment recommendations will vary, depending on the extent of the stenosis and the treatment used. In some situations, no further treatment is necessary. For more complex stenosis or surgery, a person may have further instructions to follow.

How is the condition monitored?
The meatus is examined during periodic checkups to make sure the condition does not recur. Any new or worsening symptoms should be reported to the doctor.

Author: Stuart Wolf, MD
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Potential conflict of interest information for reviewers available on request

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