What is urethral meatus

Narrowing of the urethral opening (meat stenosis)

Important NOTE:
The description of the interventions was compiled with the greatest care. However, it can only be an overview and does not claim to be complete. The websites of the service providers and the personal consultation with the doctor or the surgical explanation in the respective operating facility provide further information.
The persons responsible for the content of this website do not guarantee the completeness and correctness of the information, as constant changes, further developments and concretizations are made as a result of scientific research or adaptation of the guidelines by the medical societies.

Here you will find:

A narrowing of the urethral orifice can be congenital or it can occur as a result of inflammation. Symptoms include a weakened urine stream that may appear twisted or split, frequent urination, and painful urination. If the bladder cannot be completely emptied through the narrow opening, urinary tract infections can occur more frequently. In boys, the urethral constriction can also occur in the context of hypospadias (reference: hypospadias), in which the urethral opening is shifted to the underside of the penis.

In some cases, the narrowing of the opening can be seen with the naked eye. The doctor can determine the exact width of the urethra by carefully inserting plastic or metal rods of various diameters (so-called bougies). If the opening is too small, it must be widened by a small, outpatient procedure.

What happens during this procedure?

In many cases, the urethral slit (meatomy) is sufficient to widen the urethral opening. To do this, a special instrument is inserted into the urethral opening. Inside the instrument there is a small knife with which the narrowed area is slit open until the urethral opening is wide enough and the urine can drain freely. The small wound does not need to be sutured, but heals on its own. In order not to disturb the healing process, a urethra (catheter) is inserted for a certain period of time to drain the urine.
In the case of severe constrictions or more complicated changes, a so-called meatoplasty may also be necessary, in which the urethral opening has to be completely rebuilt.

When does the doctor advise you to have this procedure?

The doctor will always advise dilating a narrowed urethra if the opening that is too narrow causes problems when urinating. The operation is absolutely necessary if the urine backs up in the bladder in front of the narrowed opening. The doctor can tell by measuring the amount of urine remaining in the bladder. In such cases there is a risk of urinary tract infections and, sooner or later, the kidneys can also be affected.

Which stunning method is usually used?

The urethra is slit in children under general anesthesia (reference: general anesthesia).

How long does the procedure take on average?

Slitting the urethra takes only a few minutes. Meatoplasty with reconstruction of a urethral opening can take much longer.

Who may not be suitable for this procedure?

Before the procedure, the anesthetist will check that you are able to be anesthetized. If anesthesia poses too great a risk for your child, the procedure may have to be postponed or an alternative anesthetic method used.
At the time of the operation, your child should be as completely healthy as possible and any urinary tract infection should have subsided.

How is the risk to be assessed?

The operation of a narrowed urethral opening is a low-risk procedure. As with any surgical procedure, complications cannot of course be ruled out one hundred percent.
Your doctor will provide you with comprehensive information about such rare complications, such as injuries or wound healing disorders, before the operation.

What do you have to consider before the procedure?

On the day of the procedure, your child should not eat or drink any more cloudy liquids 6 hours before the anesthesia! No clear liquids should be drunk 2 hours before the anesthesia (exception: preparation tablet (s) with a little water).
If your child takes medication regularly in the morning, please discuss with the anesthetist which medications they can take before the anesthesia.

What happens after the procedure and what should you watch out for?

Even with the outpatient operation of a narrowed urethra, your child will remain under observation for some time after the procedure - until they are fit enough to go home. The anesthesia will subside relatively quickly, so that your child will soon be responsive and alert again.
A supervisor must always be present at home 24 hours after the procedure.
In most cases, a local anesthetic is administered in addition to the anesthetic immediately before the operation so that your child does not feel any pain immediately after the operation. Only when this anesthesia wears off can pain occur, which should be treated with painkillers as instructed by the doctor.
The urethra (catheter) usually remains in place for a few days until the wound has healed. The practice staff will introduce you to the use of the catheter.

When does the next doctor's appointment usually take place?

On the day of the procedure, your doctor will tell you when you should come back with your child for the next check-up. In the interests of your child, you should definitely keep this appointment.
If your child has a fever, complains of severe pain or if bleeding occurs, you should contact the doctor immediately. Even if you are unsure and still have questions about the normal course of healing, in practice no one will be angry with you if you call for advice.