Meatoplasty is a surgery in which the end of a child’s penis is surgically opened and the edges are stitched together. This procedure is done when the opening at the end of the boy’s penis is too small, making it difficult for him to urinate. Meatotomy is the surgical opening of the hole (urethral meatus) with no stitching.

Meatotomy is often done because the meatus is too narrow. This happens to about 20 percent of circumcised males. It may also be done if there’s thin or webbed skin covering the meatus. Some urologists can do this in the office with an externally applied cream called EMLA.

Who candidate for Meatotomy؟

Meatotomy is a common treatment for males whose meatus is too narrow, making it difficult to aim their urine stream when they pee, or even causing them pain when they urinate. Meatotomy is a safe, relatively painless procedure, so it can be done even when your child is as young as 3 months old.

Symptoms of meatal stenosis include:

  • trouble aiming the urine stream.
  • very thin, upward- or sideways-pointing urine stream.
  • spraying urine stream.
  • pain upon urinating.
  • need to urinate often.
  • a feeling the bladder has not completely emptied.

Meatotomy pre-operation

Notify your surgeon if you experience any significant change in your health status: develop a cold, influenza, a bladder infection, diarrhea, or other infection, before your surgery.

  • STOP all aspirin and all aspirin-containing medicines from 1 week before surgery.
  • STOP all nonsteroidal anti-inflammatory medications from 2 days before surgery
  • DO NOT TAKE oral antidiabetes medicines on the morning of your surgery.
  • DO TAKE, with a small sip of water, ALL of your other usual morning doses of regularly prescribed medicines

Meatotomy procedure

Either a full general anaesthetic or a spinal anaesthetic will be used. All methods minimise pain; The opening of the urethra is usually incised with either suturing of the edges of

the incision or insertion of a skin graft into the opening. Absorbable sutures are used and do not require removal. Occasionally, it is necessary to insert a catheter into the urethra (water pipe) after the procedure

the incision or insertion of a skin graft into the opening. Absorbable sutures are used and do not require removal. Occasionally, it is necessary to insert a catheter into the urethra (water pipe) after the procedure

for your child will be ready to go home from the outpatient facility soon after the anesthesia wears off. At most, you may wait a few hours for postoperative testing and recovery.

The average hospital stay is 1 day.

Meatotomy recovery and post-op

There are no bathing restrictions following meatotomy.  Expect frequent urination the first few days.  It is often helpful to have your child urinate while sitting in a tub of warm water. Don’t let your child do any strenuous physical activity for at least a week.  It is normal to see blood tinged urine the first 2-3 days.  If bleeding persists contact your doctor.

The opening of the penis should be spread apart by placing your thumbs on each side and gently separating the skin.  This should be done every day for one week.

Meatotomy Risks

Meatotomy is considered a safe procedure. Your child may have some of the following symptoms for a few weeks afterward:

  • burning or stinging when they pee
  • small amounts of blood in diapers or underwear
  • urine spraying when they pee until the stitches fall out

Take your child to the doctor right away if you notice any of these symptoms:

  • high fever (over 101°F or 38.3°C)
  • a lot of bleeding around the meatus
  • a lot of redness, irritation, or swelling around the meatus

Possible complications from meatotomy include:

  • spraying when peeing
  • infection of the meatus or site of surgery
  • scarring of the penis tip
  • blood clots