The word “stenosis” refers to the narrowing of a passage. In meatal stenosis the meatus, or opening at the tip of the penis, becomes narrower. This condition can be present at birth or it can occur later in life, usually between ages three and seven.
One study has found that about 9% of boys have meatal stenosis at birth. In a follow-up study of 1,800 boys aged six to ten years, visual inspection found 32% had a “pinhole” meatus. This implies that about 23% of all cases resulted after birth.
Meatal stenosis is almost always seen in males who have been circumcised. Circumcision is the surgical removal of the foreskin over the tip of the penis. It is rare for uncircumcised males to have meatal stenosis. This may mean that circumcision has caused the meatus to become narrower. Other causes of meatal stenosis include:
The symptoms of meatal stenosis occur as a result of urine flow becoming partly blocked.
Symptoms include the following:
A doctor’s physical exam and measurements of the width of the meatus with special instruments can show if meatal stenosis is present. A small, narrow meatus means that the passage is partly blocked.
However, there are natural differences in meatal widths in different males, so a narrow meatus does not necessarily indicate stenosis. The health of the patient, not just the appearance of the meatus, is the key to deciding whether stenosis is present or not. Observation of the patient during urination can determine whether the urine stream is straight or not. Also, the taking of measurements of the rate of flow can help in making the right diagnosis. An uncontrolled path of a urine stream and spraying of the urinary stream mean that a correction of the meatal stenosis is probably needed.
In some cases a steroid cream may be applied to the meatus.
In most cases, a surgery called meatotomy is the best treatment. It involves cutting apart the stuck part of the meatus so that the opening is made bigger. Following this surgery it is rare for meatal stenosis to return.
One other possible treatment is to try to stretch the opening of the meatus wider. However, this has the possible side effect of tearing the skin, which could lead to the formation of scar tissue that would make the opening even narrower.
After meatotomy, pain killers and warm baths may be taken to reduce discomfort. Bleeding is not common and can usually be controlled by pressing a bandage on the affected area.
Recovery time is about one to two days but spreading petroleum jelly or an ointment on the surgical area several times a day for one to two weeks can help the wound heal faster.
There is a wide variety of opinion about the effects of untreated meatal stenosis on the health of the urinary system. Some researchers believe the condition can lead to urinary tract infections, kidney problems, involuntary urination, or backflow of urine. Others doubt that these problems can result from stenosis alone and caution against meatotomy based only on the appearance of the meatus.
There is no way to prevent meatal stenosis that is present at birth.
Choosing to leave the penis uncircumcised would eliminate most cases of meatal stenosis. However, not circumcising may slightly raise the risks of other health problems such as urinary tract infections in young boys, some sexually transmitted diseases in men, and penile cancer.
One possible alternative to circumcision is called preputial plasty, a plastic surgery that removes the foreskin of the penis in a less invasive way.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 08/09/2016