A disorder in which the opening of the penis is narrower than expected is called meatal stenosis. While it can be present at birth (congenital), most of the time, people develop it after circumcision (between the ages of 3 and 7). People with meatal stenosis often experience symptoms after urinating (such as pain or spraying). Fortunately, there are some options available to treat this condition.
Moreover, the meatus is located at the end of the urethra. Doctors use the medical term “stenosis” to describe a passage that is narrower or smaller than normal. In general, meatal stenosis rarely occurs in adults, but it may occur after a procedure or treatment in or around the urethra. Sometimes, people may develop it due to autoimmune disorders (including lichen sclerosus).
This condition affects about 10% of men in the world.
Symptoms
While the primary symptom of meatal stenosis is a narrow meatus, it may also cause other symptoms. Check some examples below:
- Dysuria – This symptom causes pain and a burning feeling while peeing.
- Urge incontinence (sudden urges to urinate)
- Frequent urination (urinating more than usual)
- Small and narrow or very fast urine stream
- Difficulty emptying the bladder
- Hematuria (blood in the urine)
- A urine flow that sprays
If you or your child experiences any of the previous symptoms, do not hesitate to visit a healthcare professional for a diagnosis and treatment.
Causes and Risk Factors
One of the most common causes of meatal stenosis in babies is circumcision. Those who are not circumcised usually do not develop this condition. Check below for other potential causes of meatal stenosis:
- Inflammation, swelling, or an injury to a baby’s penis (it often occurs when the penis rubs against a diaper or skin in the surrounding area after circumcision).
- Pee-soaked diapers – Urine contains the waste products (such as uric and acid ammonia) that may build up and crystallize in diapers.
- Chronic (long-term) use of urinary catheters
- Surgeries or procedures in which doctors insert instruments into the urethra.
Healthcare professionals have also identified some factors that may put you at increased risk of meatal stenosis. Check some examples below:
- Circumcision
- Injuries to the penis
- Urinary catheter that is used for long periods
- Ammoniacal dermatitis – Long-term exposure of the glans to urine.
- Infections, including recurrent urinary tract infections (UTIs)
- Balanitis xerotica obliterans (BXO/Lichen sclerosus) – This condition is a chronic inflammatory skin disorder.
- Diaper use
What Are The Potential Complications of Meatal Stenosis?
In general, there are multiple opinions in the medical community about what happens if this condition is left untreated. Some of them believe that untreated meatal stenosis may lead to the following complications. These include:
- Kidney problems
- Urinary tract infections (UTIs)
- Urinating when you do not mean to
- Severe dysuria and voiding dysfunction
- Urinary incontinence
- Acute urinary retention
- Recurrent stenosis
- Hydronephrosis
This document does not contain a full list of meatal stenosis complications. However, you can talk with your doctor about ways to reduce the risk or even prevent the complications listed above.
How to Prevent Meatal Stenosis?
While there is no way to prevent congenital meatal stenosis, doctors may recommend some tips to reduce the risk of this condition. For example:
- Not circumcising children usually prevents most cases of meatal stenosis. However, not circumcising your child may increase the risk of the following health conditions. For example, sexually transmitted infections (STIs), penile cancer, and others.
- Skin care – Doctors may also recommend some ointments to prevent meatal stenosis if your child is circumcised.
- Lubrication – You can also apply Vaseline or an antibiotic ointment to the glans/meatus after each diaper change for at least 6 months post-circumcision. Commonly, it significantly reduces the risk of meatal stenosis.
- Avoid irritants – It is also advised to use gentle and fragrance-free detergents and avoid harsh soaps to prevent dermatitis.
- Regular cleaning to avoid infections and chronic (long-term) inflammation
Diagnosis
Doctors often diagnose this condition during a physical examination. During this procedure, doctors will:
- Measure the width of the meatus (sometimes, the meatus may narrow without having meatal stenosis)
- Ask questions about how your child urinates (including urine stream)
- Measure the strength of the urine stream (flow rate)
Treatment
It is important to understand that this condition does not go away on its own, and if you notice symptoms of meatal stenosis, immediately contact your doctor. Usually, doctors recommend one of the following options to treat this condition. Examples include:
- Meatotomy – This is one of the most commonly used treatments for people with meatal stenosis. During this procedure, surgeons will cut apart part of the meatus to make the opening of the penis bigger. In general, this surgery has a high success rate, and meatal stenosis rarely returns after this procedure.
- Steroid creams – In some cases, doctors may recommend topical corticosteroids to treat this condition. Usually, the cream is applied to the tip of the penis twice a day for about 3 months.
- Dilation – This is another option to treat meatal stenosis. It involves options to stretch the opening of the meatus. However, dilation may tear the skin and cause scarring that may narrow the meatus even more.
Most of the time, people begin to feel better within a few days after meatotomy. You can also administer pain relievers and take warm baths to reduce the symptoms. While bleeding occurs rarely, you can manage it by putting pressure on the area with a clean towel. You can also use skin care ointments because they help you heal faster.
Frequently Asked Questions
What does meatal stenosis feel like?
This condition often causes pain and a burning feeling when you urinate. Sometimes, it may also cause discomfort and prevent the bladder from fully draining.
When should I go to the ER?
Immediately go to the nearest emergency room (ER) or call 911 if any of the following symptoms occur. Examples include:
- A fever of 100 degrees F (about 38 degrees C) or higher
- Heavy bleeding
- Severe pain
- Difficulty urinating
- Vomiting more than 3 times per day
What can I expect if I have meatal stenosis?
In general, the prognosis of meatal stenosis in people who get treatment is good. Moreover, the success rate for a meatotomy is high, and it is less likely to recur in the future. Ask your healthcare provider if you have any other questions.
