Meatoplasty/Meatotomy

Overview

What is meatoplasty?

Meatoplasty is a surgery in which the end of a child’s penis is surgically opened and the edges are stitched together. This procedure is done when the opening at the end of the boy’s penis is too small or the shape of the hole distorts the urinary stream, making it difficult for him to urinate (pee). Meatotomy is the surgical opening of the hole (urethral meatus) with no stitching.

This opening is called the urinary meatus, or the external urethral orifice. The word meatus means opening. When the meatus is too small, it’s called meatal stenosis.

Who may need meatoplasty?

Meatal stenosis occurs in around 10% of males. It’s a common, easily treated condition that affects circumcised male infants. This is also performed on patients who have a mild form of hypospadias (a birth defect where the opening isn’t at the tip of the penis).

What are the symptoms of meatal stenosis?

Symptoms of meatal stenosis include:

  • Trouble aiming the urine stream.
  • Very thin, upward- or sideways-pointing urine stream.
  • Spraying urine stream.
  • Pain upon urinating.
  • Need to urinate often.
  • A feeling the bladder has not completely emptied.

Because meatal stenosis is most often diagnosed after potty training, it’s usually the parents who notice such symptoms. If you notice any of these symptoms in your son, you should seek medical advice. If it’s not treated, meatal stenosis may lead to urinary tract infections and kidney problems.

How is meatal stenosis diagnosed?

Your child’s healthcare provider may begin an exam by taking a urine sample to test for a urinary tract infection as a cause of any problems.

They will then physically examine your child. A visual exam can allow the provider to diagnose meatal stenosis.

Procedure Details

How is meatoplasty performed?

If your son has meatal stenosis, a meatotomy can be done to fix the problem. This is a simple procedure, usually performed on an outpatient basis. Some surgeries are performed in office with a topical anesthetic. For others, a general anesthetic will need to be used. Once your son is asleep, the provider passes a soft tube into the meatus to measure it, then makes a small cut to enlarge the opening.

Following the brief procedure, an antibiotic ointment or petroleum jelly will be applied to the area to prevent infection, and keep the site open and well lubricated.

Recovery and Outlook

Most children experience minimal pain or no pain following meatoplasty. Some stinging or burning while urinating is normal. A small amount of bloody drainage is also normal.

Children’s acetaminophen or ibuprofen and an antibiotic ointment/petroleum jelly is all that’s usually needed in the recovery period. A warm bath may also be prescribed. Your provider will advise the best post-operative care for your child, including the aftercare of the wound. Some rare complications can occur and must be dealt with quickly. Call your provider if you see any of the following:

  • Swelling or redness around your son’s meatus.
  • Excessive bleeding.
  • A fever developing in your child.

Recovery time is usually minimal following meatoplasty. Your son should be able to resume normal activities almost immediately after surgery.

Last reviewed by a Cleveland Clinic medical professional on 07/29/2020.

References

  • National Institutes of Health. Accessed 8/19/2020.Surgical Management of Meatal Stenosis with Meatoplasty (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3159600/)
  • American Urological Association. Accessed 8/19/2020.The Malone meatoplasty: A dorsal approach to meatal stenosis in patients with lichen sclerosus (https://auau.auanet.org/content/v2-03-malone-meatoplasty-dorsal-approach-meatal-stenosis-patients-lichen-sclerosus)
  • Varda BK, Logvinenko T, Bauer S, Cilento B, Yu RN, Nelson CP. J Pediatr Urol. 2018;14(2):165.e1-165.e5.Minor procedure, major impact: Patient-reported outcomes following urethral meatotomy. (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5957770/)

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