Meatal stenosis was an abnormal condition of narrowing the urethral meatus in males. This refers to the size of opening at the penis tip. This condition is generally attained but may exist from birth. Meatal stenosis is the most commonly related with circumcision and is occasionally observed in uncircumcised males. It is possible that the newly exposed penis tip (including the meatus) suffers by mild injury as it was rubs against to the diaper or the child’s own skin. Over the time this constant irritation may results in narrowing and scarring of the meatus. It may also result from mild ischemia that can occur with circumcision. In females, this situation will present at birth (congenital). Less commonly, meatal stenosis can also affected by adult women.
CAUSES:
Child who is circumcised, there will be persistent exposure of meatus to urine and mechanical trauma by rubbing against a wet diaper that results in loss of meatal epithelium, ammoniacal dermatitis and fusion of the ventral edges. This may results in the pinpoint orifice at the glans tip. Other causes of meatal stenosis that may include the following:
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Prolonged catheterization
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Unsuccessful hypospadias repair
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Trauma
SYMPTOMS:
Abnormal strength & direction of the urinary stream, observable narrow opening at the meatus in boys,
Swelling, Irritation and scarring of the meatus seen in boys, discomfort while passing urination (dysuria and frequency), Incontinence (day or night), bleeding (hematuria) at the end of urination, urinary tract infections – more susceptibility due to stricture.
DIAGNOSIS:
History and physical examination were adequate to diagnose this disease. But this should be correlate with urinary obstruction and urinating symptoms. Upon the close inspection, the lower surface of the meatus was usually adhered. Measuring the meatus is usually unnecessary and may expose the patient to advanced risk of injury.
Treatment may involves by a second surgical treatment known as meatotomy in this the meatus was crushed by a straight mosquito hemostat and after then separated with fine-tipped scissors. Newly, home-dilation was also been shown to be a successful and effective treatment for most of the boys.
