Surgical Management of Meatal Stenosis with Meatoplasty

Summary

Meatoplasty, surgical management of meatal stenosis.

Abstract

Meatal stenosis is a common urologic complication after circumcision. Children present to their primary care physicians with complaints of deviated urinary stream, difficult-to-aim, painful urination, and urinary frequency. Clinical exam reveals a pinpoint meatus and if the child is asked to urinate, he will usually have an upward, thin, occasionally forceful urinary stream with incomplete bladder emptying. The mainstay of management is meatoplasty (reconstruction of the distal urethra /meatus). This educational video will demonstrate how this is performed.

Protocol

Introduction:

Genital disorders are commonly encountered in the offices of primary care physicians. Meatal stenosis, an abnormal narrowing of the urethral opening (meatus) is a common complication after circumcision occurring in 9%-10% of males. This disorder is characterized by an upward deflected, difficult-to-aim urinary stream, dysuria, urgency, frequent, and prolonged urination. If left untreated, this can lead to urinary tract infections and kidney problems. Surgical meatotomy/meatoplasty is curative.

Treatment/Diagnostics Procedure:

A routine urine analysis will rule out urina....

Discussion

Outcome:

Symptomatic meatal stenosis is frustrating for the child and family. If left untreated, there is a potential for chronic incomplete bladder emptying, with occasional development of urinary tract infection and subsequent kidney damage.

Reconstructive meatoplasty is curative, and can be done under a brief anesthetic.

Conclusion:

Meatal stenosis is a common complication of circumcision. A thorough histor.......

Materials

List of materials used in this article

Name	Company	Catalog Number	Comments
Betadine
Mosquito hemostat
Microsurgical scissor
Castroviejo needle driver
7-0 vicryl suture	Ethicon Inc.