USA Pediatric Surgeon Lisa Smith answers common questions about meatal stenosis and effective surgical treatment.

Q: WHAT IS MEATAL STENOSIS AND WHO DOES IT AFFECT? 

A: “Meatal stenosis is a disorder that affects boys. It occurs when the opening of the penis (called the meatus) that allows urine to escape from the bladder becomes narrowed or restricted. Some boys are born with the condition, and some develop it as consequence of inflammation or infection of the foreskin in those who are not circumcised. The condition also can occur in circumcised boys when the blood supply to the tip of the penis is disrupted. It can also result from injury to the penis tip or because of extended use of urinary catheters.”

Q: WHAT ARE THE MOST COMMON SYMPTOMS? 

A: “Meatal stenosis can present in a couple of ways, and the most common symptoms include frequency, small volume, and even new-onset bedwetting.

Boys with the condition tend to go to the bathroom frequently but have a very low volume of urine. You may also see them kick back and push to get started peeing, with a urinary stream that sprays or is difficult to aim. Bedwetting can occur because they have difficulty emptying their bladder completely at bedtime, and they may even complain of discomfort while voiding.

These symptoms often become apparent when your child starts toileting independently – typically during the grade school years. “

Q: HOW IS THE CONDITION EVALUATED AND TREATED? 

A: “Diagnosis of meatal stenosis is straightforward – it requires an appropriate history and physical exam. There’s no need to physically measure the penis opening – when it’s smaller than the tip of a pen, they need an operation.

A meatomy or meatoplasty is the procedure performed to widen or enlarge the penis opening.

It’s a safe procedure that only requires a light anesthetic. The operation itself takes only minutes, and there is minimal trauma to the body. All sutures or stitches are absorbable and will dissolve on their own. After the procedure, the child immediately begins voiding more comfortably and bedwetting related to the condition is typically resolved.”

Q: WHAT IS THE RECOVERY TIME? 

A: “Full recovery for meatal stenosis is fast, and patients should void much better right away. After the procedure, have your child wear loose fitting underwear and drink plenty of clear liquids. One way to ease discomfort is to apply antibiotic ointment or petroleum jelly to the tip of the penis several times a day for the first two weeks.

We like to see our patients in the office at the two-week mark to make sure everything is healing properly.”

Q: DO YOU NEED A REFERRAL TO SEE A SPECIALIST? 

A: “A referral is not required for an evaluation of meatal stenosis. If you child is suffering from these symptoms, we are happy to evaluate them and provide direction on the best course of treatment.”

University Surgical Associates’ pediatric surgeons manage general surgery issues in children, from appendicitis to gallbladder disease, as well as the subspecialty cases such as congenital deformities, newborn surgery, urologic reconstructive surgery, chest wall reconstruction, childhood cancers and minimally invasive surgery. To schedule an appointment, call 423.267.0466.