Meatal stenosis (mee-ay-tal) is the medical term used to describe a narrowing at the end of the urine channel on the tip of the penis. No one knows for certain what causes meatal stenosis. Some urologists feel that irritation of the penis from urine in a baby's diaper can cause inflammation, which makes the skin edges stick together, narrowing the urine channel. Meatotomy (mee-ay-taw-toe-mee) is the name of the surgery, which opens the urine channel.
Is meatal stenosis dangerous?
Most boys who have meatal stenosis have some narrowing of the urine stream. It may be hard to direct the stream or it may come out of the penis at an angle. Some boys with meatal stenosis have a small amount of blood at the end of the urine stream. This can appear on a diaper or underwear. Rarely, boys with meatal stenosis may have urine infections.
If it isn't dangerous, why should my son have surgery?
Although most boys with meatal stenosis have relatively minor problems, as they grow, these boys usually notice more symptoms. A young boy with a narrowed urinary stream will have more difficulty urinating as he gets larger and produces more urine. It is best to take care of the problem before the symptoms get worse.
How is the surgery done?
The surgery is usually performed in the outpatient clinic with local anesthetic. A special cream is applied to the end of the penis and covered with a membrane dressing that looks something like Saran Wrap. About 20 minutes later the penis is numb. Occasionally the procedure is done in the operating room under a brief general anesthesia.
A small slit is made in the web of skin covering the urine channel. Sometimes we place three small stitches to keep the skin edges together. These stitches dissolve so they don't need to be removed.
Are there any possible complications with the surgery?
There are very few complications with a meatotomy. The most common complication is a return of the narrowing at the tip of the urine channel. We try to avoid this by having parents separate the skin edges and put some antibiotic ointment into the urine channel twice a day for two weeks. This helps keep the urine channel open.
How is the surgery scheduled?
If the surgery is to be performed in the outpatient clinic, you can make the appointment directly with the clinic. Please mention to the assistant that you wish to schedule a clinic meatotomy (procedure).
If it is decided that the surgery is to be performed in the outpatient surgery center you should receive a phone call from our secretary after your child is evaluated in the office. If you don't hear from her, please call her at 04-349 6666.
Is there anything I can do to prepare my child for surgery?
Infants do very well with surgery. Children who are old enough to talk are sometimes anxious if they don't know what will happen to them. You can ease this fear by talking about the upcoming surgery. Many local libraries have books or video tapes about going to the hospital or doctor's office. We also have a video tape which can explain the Outpatient Surgery Center to children. Children are often fearful of an unfamiliar environment. It may help to bring a favorite toy or blanket on the day of surgery.
Like children, parents also are sometimes anxious about the unknown. Don't hesitate to ask questions. We want you to have all of the information you need about your child's care. It may help to write down questions as you think about them. Bring them with you to your child's appointment and we will be happy to answer them.