Meatus stenosis is a narrowing of the urethral opening. It is either congenital or occurs as a result of injury or inflammation.
What is meatal stenosis?
Meatal stenosis causes a narrowing of the opening of the urethra (urethra). Just like the urethral valve, meatal stenosis also represents an infravesical obstruction. A congenital narrowing of the urethral orifice often becomes noticeable in childhood. It is more common in males due to their longer urethra. See AbbreviationFinder for abbreviations related to Meatal Stenosis.
The urethral orifice is part of the human urethra, the function of which is to drain urine in both men and women. Urine collects inside the urinary bladder and from there travels to the urethra, where it is excreted from the body. However, a narrowing of the urethra or the urethral orifice can lead to disorders of this function.
The causes of meatal stenosis vary. The narrowing of the urethra can already exist since birth. Inflammations such as meatitis or balanitis, injuries or tumors of a benign or malignant nature can also cause the stenosis. In addition, meatal stenosis is a complication of circumcision of the foreskin of the penis (circumcision).
The frequency is given as nine to eleven percent. Since the narrowing of the urethral orifice restricts the quality of life of those affected, rapid medical treatment is recommended. It is not always possible to find a specific cause for the narrowing of the urethra, which is particularly true for patients under the age of 45. In older patients, surgical interventions are primarily responsible for subsequent meatal stenosis.
Symptoms, Ailments & Signs
A typical symptom of meatal stenosis is the weakening of the urinary stream. In some cases, this is also split or twisted. Furthermore, the affected persons suffer from a frequent urge to urinate and pain when urinating. If the bladder cannot be emptied regularly, there is a risk of further sequelae such as urinary tract infections, which appear repeatedly.
In males, narrowing of the urethral orifice is often accompanied by hypospadias. The opening of the urethra shifts to the lower side of the penis. If a meatal stenosis occurs in females, this becomes noticeable, among other things, through repeated urinary tract infections. In addition, voiding is difficult.
Other possible symptoms are enuresis (wetting) and the formation of residual urine. In some people, a urethral stricture can also result in a complete urethral blockage. In such cases, patients experience significant pain. Even an accumulation of urine up to the kidneys is conceivable.
If this kidney congestion is not treated, there is a risk of life-threatening complications. In men there is also a risk of scarring of the erectile tissue. Doctors then speak of spongiofibrosis, which in turn leads to erectile dysfunction.
Diagnosis & disease progression
If meatal stenosis is suspected, it is recommended to see a urologist who specializes in the treatment of urinary tract disease. He does a physical exam of the patient. It is not uncommon for the doctor to be able to see the stenosis with the naked eye. Another examination method is the urethral calibration.
In this procedure, the doctor gently inserts metal or plastic rods of varying diameters into the urethra. In this way, the extent of the meatal stenosis can be determined. If the opening is too small, a minor surgical intervention is usually required. The urodynamic relevance can be clarified by measuring the urinary stream.
In order to rule out tumors in the urethra, a urethral endoscopy is recommended. If the meatal stenosis is not treated, there is a risk of urinary retention and renal dysfunction, which have a negative impact on the patient’s quality of life. However, there is a risk of a relapse, even if the therapy is successful.
In most cases, those affected with meatal stenosis suffer from a greatly reduced water jet. Pain when urinating can also occur, which significantly reduces the patient’s quality of life. The pain can also be burning and often lead to depression or other psychological problems.
Sometimes those affected are often ashamed of the symptoms and suffer from an inferiority complex. Furthermore, infections of the urinary tract can also occur, which are also associated with severe pain. Kidney congestion can also occur due to meatal stenosis and lead to dangerous symptoms. In the worst case, this can lead to kidney failure, which if left untreated can lead to death. #
Erectile dysfunction can also occur due to meatal stenosis and lead to tension with the partner or to depressive behavior. The patient’s quality of life is significantly reduced and limited by this disease. Meatus stenosis is treated by surgery.
Usually there are no complications. However, various disorders can occur during wound healing, so that those affected may need to take antibiotics. Life expectancy is usually not reduced if treatment is successful.
When should you go to the doctor?
A permanently reduced stream of urine is already a sign of an existing health problem. It must be examined by a doctor so that a diagnosis and subsequent treatment can be made as quickly as possible. If the person affected suffers from a frequent urge to urinate, which often occurs immediately after going to the toilet, a doctor should be consulted. Painful urination and the inability to completely empty the bladder should be checked out by a doctor. A backlog of urine leads to complications and can trigger other diseases.
If it is noticed, it is therefore advisable to consult a doctor. There is a health impairment that must be treated immediately to prevent kidney dysfunction. If the situation deteriorates further, there is a risk of organ damage or kidney failure. Repeated infections of the urinary tract or the bladder should be clarified in consultation with the doctor treating you. If men suffer from a narrowing of the urethra, this should also be discussed with a doctor. If you have night-time wetting, insomnia or a general feeling of being unwell, you should see a doctor. If abdominal pain occurs and increases in intensity, a doctor’s visit is necessary.
Treatment & Therapy
Meatus stenosis is always treated with surgery. So far, other therapeutic measures have proven to be ineffective. Meatotomy (urethral slit) is the surgical method of choice. During this procedure, in which the patient is given general anesthesia, the opening of the urethra is widened. The surgeon inserts a special instrument equipped with a small knife into the opening.
The knife slits open the constriction so that the urine can drain unhindered again. Stitching up the small wound is not necessary as it heals on its own. In order for the healing process to proceed undisturbed, the patient is temporarily given a catheter with which the urine is drained. Meatotomy is not complicated. It only takes a few minutes and is usually carried out on an outpatient basis.
Possible surgical risks such as wound healing disorders or injuries only occur rarely. If there is a pronounced or complicated meatal stenosis, a meatoplasty is usually carried out. With this surgical method, the opening of the urethra is completely rebuilt. A surgical procedure is carried out if the patient suffers from problems with urination. If there is a blockage of urine, the operation must take place in any case.
A few check-ups are still necessary for the follow-up treatment of the meatal stenosis. An operation cannot be carried out if the general anesthetic poses too great a risk for the patient, which can be the case in children in particular.
Outlook & Forecast
The prognosis of meatal stenosis is favorable. Regardless of whether the disorder is congenital or develops over the course of life, there are good treatment options that lead to a cure of the condition. Surgical intervention is mandatory. Although this is associated with risks and the possibility of complications, it is a routine process that usually runs smoothly.
Under optimal conditions, the patient can be discharged from treatment as recovered within a short period of time. Normally, the symptoms do not return. A stable state of health of the affected person and good wound healing are important for a smooth course. Since the patient is put under general anesthesia, there should be no other previous illnesses or a weakened immune system. If these risk factors can be ruled out, the prognosis is very favorable.
This prospect changes as soon as wound healing disorders or infections occur. In addition, in an untreated condition, the development of meatal stenosis is significantly worsened. Here the patient is threatened with an unfavorable course of the disease. There is a backlog of urine, which significantly impairs the functioning of the kidneys. There is a possibility that a life-threatening condition could develop. If no measures are taken in this phase either, the patient may die prematurely.
It is hardly possible to prevent meatal stenosis. In some cases, it has existed since birth. In addition, the specific causes of the narrowing are often unclear.
The quality of life of those affected is significantly reduced and limited by the meatus stenosis, which is why it is treated with the help of a surgical procedure in most cases. Normally, there are no further complications during the treatment. However, disturbances in wound healing can occur. In this case, those affected must also take antibiotics. The life expectancy of those affected is usually not restricted or reduced. Old age can be reached.
You can do that yourself
Meatus stenosis must always be treated surgically. Accordingly, self-help measures focus on relieving symptoms and promoting recovery after urethral surgery.
In the first few days after the operation, the patient should take it easy. Physical work should be avoided, as should exercise and other measures that could lead to a tear in the wound. After two to three weeks, the wound should have healed completely and the patient can put weight on their body as usual. The area around the incision should be groomed as directed by the doctor. With the medical professional’s understanding, natural ointments and lotions can be used to treat the wound. Suitable preparations are, for example, marigold ointment or zinc ointment. Applications with lemon balm or chamomile can also promote the healing of the wound.
If wound healing disorders, bleeding or other complications occur, a doctor’s visit is indicated. Patients should generally visit their doctor regularly after an operation on the urethra, because serious symptoms and complications can only be reliably ruled out with regular check-ups.