Meatal Stenosis

What is meatal stenosis?

Meatal stenosis (mee-AY-tull stuh-NO-sus) is a condition where the opening at the tip of your penis (meatus) becomes narrow. Your meatus is at the end of your urethra. The term “stenosis” means that a passage in your body is narrower or smaller than normal.

Meatal stenosis can be present at birth (congenital) or it can develop later in life. If you develop meatal stenosis, it usually occurs between the ages of 3 and 7.

What is meatal stenosis in adult males?

Meatal stenosis isn’t common in adults. If it develops, it usually occurs because of a procedure or treatment in or around your urethra. It can also develop from an autoimmune disorder such as lichen sclerosus.

How common is meatal stenosis?

Worldwide, between 8% and 10% of people assigned male at birth (AMAB) have meatal stenosis.

What are the symptoms of meatal stenosis?

The main symptom of meatal stenosis is that the meatus is narrower than usual. This can partly block your urine (pee) flow and cause symptoms such as:

• Pain or a burning feeling while peeing (dysuria).
• Sudden urges to pee (urge incontinence).
• Peeing more than usual (frequent urination).
• A small, narrow and/or very fast pee stream.
• A pee flow that sprays (usually upward) or is difficult to aim.
• Difficulty completely emptying your bladder.
• A drop of blood at the tip of your penis after peeing (hematuria).

What does meatal stenosis feel like?

Meatal stenosis can cause pain or a burning feeling when you pee. It can also cause discomfort if it prevents you from fully draining your bladder when you pee.

What causes meatal stenosis?

The most common cause of meatal stenosis in babies is circumcision. It’s rare for uncircumcised people to have meatal stenosis.

Other possible meatal stenosis conditions may include:

• Inflammation, swelling or an injury to a baby’s penis, usually when the penis rubs against a diaper or skin in the surrounding area after circumcision.
• Pee-soaked diapers. Pee contains the waste products uric acid and ammonia, which can build up and crystallize in diapers.
• Long-term use of urinary catheters.
• Surgeries or procedures in which a healthcare provider inserts instruments into your urethra.

Who does meatal stenosis affect?

In babies, meatal stenosis is more common after a circumcision.

In older children and adults, meatal stenosis is more common after an injury to the penis or using a urinary catheter for a long time.

What are the complications of meatal stenosis?

There are many different opinions in the medical community about what can happen if you don’t treat meatal stenosis. Some medical experts believe that untreated meatal stenosis may lead to:

• Urinary tract infections (UTIs).
• Kidney problems.
• Peeing when you don’t mean to.

Other experts doubt that these complications can develop from meatal stenosis alone. They recommend surgery only if these complications develop, not just if your meatus is narrow.

Talk to a healthcare provider about how untreated meatal stenosis can affect you or your child.

How is meatal stenosis diagnosed?

A healthcare provider can typically diagnose meatal stenosis during a physical examination. During a physical exam, they’ll:

• Measure the width of the meatus. There are natural differences in meatal widths. You could naturally have a narrow meatus without having meatal stenosis.
• Ask questions about how you or your child pees, including in which direction your pee flows or if there’s any spraying.
• For babies and younger children, they may observe your child while they pee to see if the stream is straight or sprays.
• Measure the strength of the pee stream (flow rate).

Can meatal stenosis correct itself?

No, meatal stenosis can’t correct itself.

How do you fix meatal stenosis?

There are several ways to treat meatal stenosis.

In most cases, a meatotomy is the best way to fix meatal stenosis. A meatotomy is a surgical procedure that involves cutting apart part of the meatus so the opening is bigger. It has a high success rate — it’s rare for meatal stenosis to come back after a meatotomy.

In some cases, a steroid cream (topical corticosteroid) can treat meatal stenosis. You apply the steroid cream to the tip of your penis. You may need to apply the cream twice a day for up to three months.

Another possible treatment option is to stretch the opening of your meatus (dilation). However, dilation may tear your skin and cause scarring. Scar tissue can make the meatus even narrower.

How do you treat meatal stenosis in adults?

The best way to treat meatal stenosis in adults is a meatotomy.

How soon after meatal stenosis treatment will I feel better?

It takes a few days to feel better after a meatotomy. You can reduce discomfort with pain relievers and warm baths. Bleeding isn’t common. But you can control any bleeding by putting pressure on the area with a clean towel.

Applying a skincare ointment (Vaseline® or Aquaphor®) to your affected areas twice a day for a few weeks can help you heal faster.

Can meatal stenosis be prevented?

There’s no way to prevent congenital meatal stenosis.

Not circumcising your child would also prevent most cases of meatal stenosis. But not circumcising may slightly increase your child’s risk of developing other health conditions, including:

• Sexually transmitted infections (STIs).
• Penile cancer.

If you circumcise your child, applying a skincare ointment may help prevent meatal stenosis from developing.

What can I expect if I have meatal stenosis?

With treatment, the outlook for meatal stenosis is good. The success rate for a meatotomy is high, and the odds of meatal stenosis coming back after the procedure are low.

When should I see a healthcare provider?

Call a healthcare provider if you or your child:

• Can’t pee comfortably.
• Can’t pee at all.
• Feel pain when you pee.

When should I go to the ER?

Go to the nearest emergency room if you or your child develops any of the following symptoms or complications after a meatotomy:

• A fever of 100 degrees Fahrenheit (38 degrees Celsius) or higher.
• Heavy bleeding.
• Increased pain.
• Vomiting three or more times a day.
• Difficulty peeing.
• A regularly dry diaper.

What questions should I ask a healthcare provider?

You may want to ask your healthcare provider:

• How do you know my child has meatal stenosis?
• If my child doesn’t have meatal stenosis, what other condition might they have?
• How did my child get meatal stenosis?
• How narrow is my child’s meatus?
• Does my child need treatment?
• What treatment do you recommend?
• What’s the complete list of risks of your recommended treatment?

A note from Cleveland Clinic

Meatal stenosis is when the opening at the tip of your penis is narrower than usual. It may be present at birth, but it most commonly appears after circumcision. Not circumcising your child can help prevent meatal stenosis. But there are pros and cons to circumcision, and choosing whether to circumcise your child or not is a personal decision that generally depends on your personal, religious and cultural beliefs. Talk to a healthcare provider if you think you or your child has symptoms of meatal stenosis. They can diagnose the condition and recommend the proper treatment.