Meatal stenosis is a common pediatric urological condition where the meatus—the external opening of the urethra becomes narrowed, restricting the flow of urine. It occurs most often in circumcised boys, leading to symptoms like painful urination (dysuria), spraying of urine, and incomplete bladder emptying.
Though meatal stenosis may seem minor at first, if left untreated, it can cause bladder dysfunction, recurrent urinary tract infections (UTIs), bedwetting, and voiding problems. Early diagnosis and a short corrective procedure can provide lasting relief and protect bladder health.
What Is Meatal Stenosis?
- A condition in which the urethral opening becomes abnormally narrow, usually at the tip of the penis
- Most commonly seen in boys who are circumcised, often due to irritation or scarring
- Can affect urine stream, bladder pressure, and overall urinary hygiene
Common Causes of Meatal Stenosis
- Circumcision-related scarring, especially without adequate lubrication post-surgery
- Recurrent irritation from ammonia in diapers or rubbing against clothes
- Inflammation or infection of the meatus (meatitis)
- Poor hygiene, particularly in active toddlers
- Less common in uncircumcised boys due to the natural protective layer of the foreskin
Signs and Symptoms to Watch For
- Thin, weak, or spraying urine stream
- Straining to urinate
- Dribbling after urination
- Painful urination (dysuria)
- Foul-smelling urine or recurrent UTIs
- Bedwetting or daytime wetting due to incomplete emptying
- Irritability during urination, especially in toddlers
- Redness or inflammation at the tip of the penis
If your child shows these symptoms, a pediatric urologist consultation is essential.
Diagnosis of Meatal Stenosis
Diagnosis is done through:
- Clinical examination of the penis and meatus
- Observation of urine stream or spraying pattern
- Urinalysis and culture if UTIs are suspected
- Uroflowmetry or post-void residual scan in older children
- No invasive imaging is usually needed
In expert hands, the condition can be quickly identified during a routine check.
Treatment Options for Meatal Stenosis
Observation
- For mild cases with no voiding difficulty or infection
- Regular monitoring and hygiene care
Meatal Dilation (Temporary Relief)
- Gently enlarging the opening with a dilator
- Often uncomfortable and not a permanent solution
- May lead to repeated scarring if done frequently
Surgical Correction – Meatoplasty or Meatotomy
Performed by a pediatric urology specialist:
- Short daycare procedure under anesthesia
- A small incision is made to widen the meatus
- Takes 15–20 minutes, with no stitches required in most cases
- Child goes home the same day
- Normal urine flow resumes within 24–48 hours
Postoperative Care & Recovery
- Mild discomfort or burning for 1–2 days
- Application of antibiotic ointment to prevent re-stenosis
- Child can return to normal activities in 2–3 days
- Full healing usually occurs in 7–10 days
- Excellent long-term results with minimal recurrence if done by a specialist
Preventing Meatal Stenosis
- Gentle handling and hygiene post-circumcision
- Apply lubricating ointments if inflammation occurs
- Avoid harsh soaps and ensure proper cleaning after urination
- Early consultation for spraying stream or urination difficulties
Meatal stenosis in children is treatable and preventable. With expert care, children can enjoy normal, pain-free urination and avoid future complications. If your child is showing signs of urine stream issues, spraying, or painful urination, it’s time to consult a pediatric urologist without delay.
Schedule an appointment with Dr. Sadashiv Bhole, Nagpur’s leading expert in pediatric foreskin and urinary surgeries, for accurate diagnosis and safe, lasting treatment.
