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    Meatal stenosis

    Definition

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

    Alternative Names

    Urethral meatal stenosis

    Causes

    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

    Exams and Tests

    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

    Treatment

    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.

    Outlook (Prognosis)

    Most people can expect normal urination after treatment.

    Possible 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.

    When to Contact a Medical Professional

    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.


    Review Date: 7/28/2004
    Reviewed By: Scott M. Gilbert, M.D., Department of Urology, Columbia-Presbyterian Medical Center, New York, NY. Review provided by VeriMed Healthcare Network.
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