A meatotomy is a simple procedure that can improve your boy’s urinary stream if the opening for urine flow (meatus) is thought to be narrowed.
The meatus is the opening that allows urine to leave the penis. If this opening is not big enough, the child will have difficulty urinating or it may cause him pain.
Normally, a small meatus is discovered with toilet training and can present as urinary spraying or deflection of stream. This is called meatal stenosis and can lead to incomplete bladder emptying and urinary tract infections. Meatal stenosis can be fixed by performing a meatotomy, which is a procedure to widen the meatus.
Meatotomy vs. Meatoplasty
In a meatoplasty, the glans of the penis is cut open and the meatus widened. A meatoplasty is a more in-depth procedure to correct similar problems, and stitches may be needed.
Diagnosing a Narrow Meatus
In a small baby, it may not be immediately obvious that the meatus is too narrow. Most of the time this is found some time after a circumcision due to the urethral opening having some inflammation. As your child grows, he may show signs that his meatus is not wide enough:
- His bladder may still seem full after going void
- He may have a hard time controlling the spray of his urine, and his stream may go up instead of down
- His urine may not be a stream and just spray everywhere
- Rarely, your child will complain of pain with urination, may void frequently, may occasionally have blood at the tip of the penis with voiding and may get a UTI
A physical exam is required to determine that the meatus is too narrow and to recommend a meatotomy. Some urologists also observe the stream to make sure that the stream is narrow and/or deflected before considering meatotomy.
The type of anesthesia used for the procedure is up to the surgeon and dependent on the extent of the surgery required. Some meatotomies can be done with topical or local anesthesia, while some may be done under general anesthesia. It is an outpatient procedure, so your son should go home the same day.
Your son should be fully healed within a few days. Usually over-the-counter (OTC) pain medications can be used, if anything is needed at all for pain. An antibiotic ointment should be applied to the tip of the penis as for a duration recommended by your child’s urologist following surgery. Warm baths can also help relieve pain and swelling.