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What to Know About Meatal Stenosis

Medically Reviewed by Dany Paul Baby, MD on April 27, 2022

Sometimes something as small as a pee hole can cause you trouble that you can’t live with. When it is blocked, passing urine can be a painful and unpleasant experience. The penis is a sensitive body part and a seemingly small issue could cause more serious complications. The good news is that it is possible to get treatment for meatal stenosis.

What Is Meatal Stenosis?

The meatus is the opening at the tip of the penis, also referred to as a pee hole. Stenosis means that a passage in your body is narrower than normal. Meatal stenosis, therefore, is a condition that causes the opening of the penis to become small. This can cause problems with urination. Though this condition can be present at birth, it’s more commonly acquired during your lifetime. If you’re not born with it, meatal stenosis is mostly always caused by trauma to the penis that also hurts the pee hole.

Causes of Meatal Stenosis

The pee hole can decrease in size due to various factors, including long-time use of urinary catheters. Other known causes include:

Injury to the penis. Meatal stenosis is mostly caused by injury to the meatus. It is commonly thought that during circumcision (removal of the foreskin), the meatus sustains an injury that leads to its narrowing. Meatal stenosis is rarely reported among uncircumcised males. Other injuries that affect the pee hole can also lead to this condition.

Inflammation. The uric acid and ammonia crystals found present in the urine can cause an inflammation of the meatus over time and cause it to narrow. This could be one of the leading causes of the condition in boys. That is why it is important to change your son’s diapers as soon as possible. That helps to prevent the inflammation associated with the urine crystals.

Glans ischemia. Sometimes, like during circumcision, blood flow is reduced to the penis causing what doctors call ischemia of the glans penis, leading to meatal stenosis Some of the procedures in use during circumcision such as numbing injections can cause reduced blood and oxygen flow to the penis. 

Hypospadias treatment. Hypospadias is a birth defect where the penis fails to develop normally. The pee hole of a person with this condition isn’t located at the tip of the penis. It can be anywhere along the underside of the penis. When corrective surgery is done to treat hypospadias, the meatus can get blocked.

Is Meatal Stenosis Serious?

The penis plays important excretory and reproductive roles in the body. It carries urine and sperm out of the body through the urethra. The meatus, which normally appears as a vertical slit, measures an average of 5.4 mm in length for children, and 8 mm for adults. A narrow meatus can affect your quality of life significantly.

When the meatus narrows, it interferes with the normal passage of urine. If the narrowing is significant, some urine may be left in the bladder, leading to conditions such as urinary tract infections and kidney problems.

How to Know If You Have Meatal Stenosis

Your doctor will conduct a physical exam to determine how small your meatus is. In most cases, they will find that the pee hole is partly blocked with the lower part stuck together. If the doctor establishes that your urine stream is uncontrolled, it could mean that you have meatal stenosis. Other symptoms may help to confirm the diagnosis. For instance:

  • Feeling pain or a burning sensation while urinating
  • Feeling a sudden urge to urinate
  • Spraying instead of urinating in a single stream
  • Needing to urinate a lot more than usual
  • Not being able to aim when urinating
  • You notice a drop of blood at the tip of the penis after urinating

Treating Meatal Stenosis

It is not recommended to try any home treatment methods. While some people have been known to try expanding the pee whole manually, it is dangerous and can lead to tears, scarring, and further narrowing. Your doctor will most likely recommend minor surgery to correct the issue.

Meatoplasty

Since meatal stenosis doesn’t seem to correct itself, the best way to treat the condition is through surgery. The procedure is also called meatotomy and involves cutting to extend the pee hole to normal size. The results of this surgery are permanent. 

What To Expect During Meatoplasty

Meatoplasty is performed by a urologist, a doctor of the urinary system. They may choose to put you to sleep to avoid a painful experience. A cut is made to increase the length of the meatus. The extension is kept in place by absorbable stitches that won’t have to be removed later. 

You’ll then take care of the wound, which should fully heal within two to three weeks. To do so, staying hydrated is important, as well as following your doctor’s instructions on cleaning to prevent further complications. Your doctor will instruct you on how to gently treat the meatus with antibiotic cream or jelly. Watch out for pus, or more pain than you can bear, in which case you should go back to the doctor.

Preventing Meatal Stenosis

It is not possible to prevent this condition if someone is born with it. Remaining uncircumcised may help to protect against a narrowed meatus. This doesn’t mean that all people who undergo circumcision will develop the condition. Proper care during and after the procedure goes a long way to keeping the pee hole in normal condition. 

It is your choice to consider circumcision. Before making a decision, make a point of consulting your doctor and asking to know about the benefits and risks involved.

Conclusion

Although not a serious condition, meatal stenosis could possibly lead to further complications if left untreated. Furthermore, you can’t ignore an issue that affects how you pass urine. If you’re concerned about your son’s penis health, talk to your doctor before deciding to move forward with certain medical procedures such as circumcision. 

Show Sources

SOURCES:

BJU International: “Normal anatomy of the external urethral meatus in boys: implications for hypospadias repair.”

Cincinnati Children's Hospital Medical Center: “What is Meatal Stenosis?”

Cleveland Clinic: “Meatal Stenosis.”

Journal of the Pakistan Health Association: “Minor Surgical Procedures: URETHRAL DILATATION.”

Medicine: “Acute glans ischemia after circumcision successfully treated with low-molecular-weight heparin and topical dihydrotestosterone.”

The Nemours Foundation: “Meatoplasty.”

Urology Care Foundation: “What is Hypospadias?”

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