What to Expect from Meatotomy
What’s a meatotomy?
Meatotomy is a surgery done to widen the meatus. The meatus is the opening at the tip of the penis where urine leaves the body.
Meatotomy is often done because the meatus is too narrow. That’s a condition known as meatal stenosis or urethral stricture. This happens to about 20 percent of circumcised males. It may also be done if there’s thin or webbed skin covering the meatus.
This procedure is most commonly done on young, circumcised males.
What’s the difference between meatotomy and meatoplasty?
Meatoplasty is done by opening the glans — the tip of the child’s penis — with an incision, and using sutures to stitch together the edges of the area that was opened. This helps widen the area around the meatus in order to make peeing easier. This may also result in a much larger hole for urine to come out.
Meatotomy is simply the procedure of making the opening of the meatus larger. Stitches may not be used in a meatotomy, and the surrounding tissue may not be modified at all.
Who’s a good candidate for a 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.
See your doctor if your child has one or more of the following symptoms of meatal stenosis or other conditions that can cause the meatus to narrow:
- difficulty aiming their urine stream when peeing
- their urine stream going up instead of down or spraying
- pain while peeing (dysuria)
- having to pee frequently
- feeling like their bladder is still full after peeing
How’s a meatotomy done?
Meatotomy is an outpatient surgery. That means it can be done in a single day without having to admit your child to the hospital. Your doctor will talk with you about which anesthesia is best for your child, as several options are available:
- Topical anesthesia. Your doctor applies an anesthetic ointment, such as lidocaine (EMLA), to the tip of the penis to numb the area before the procedure. Your child will remain awake during the procedure.
- Local anesthesia. Your doctor injects anesthesia into the head of the penis, which causes numbness. Your child will remain awake during the procedure.
- Spinal anesthesia. Your doctor injects anesthesia into your child’s back to numb them from the waist down for the procedure. Your child will remain awake during the procedure.
- General anesthesia. Your child will be asleep during the whole surgery and wake up afterward.
To perform a meatotomy, after your child has received anesthesia, your doctor or surgeon does the following:
- Sterilizes the tip of the penis with an iodine solution.
- Wraps the penis in a sterile drape.
- Crushes the tissues on one side of the meatus to permit ease of cutting.
- Makes a V-shaped cut on the bottom of the penis from the meatus.
- Stitches the tissues back together so that the meatus looks like a slit and the tissues heal properly, preventing further issues.
- Inserts a probe into the meatus to make sure there aren’t any other narrow areas.
- In some cases, inserts a catheter into the meatus to help with urination.
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.
For major procedures, your child may need to recover in the hospital for up to 3 days.
What’s recovery like from a meatotomy?
Your child will recover from a meatotomy in a few days. Any stitches used will fall out in a matter of days and don’t need to be removed by your doctor.
To take care of your child after a meatotomy:
- Give your child a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen (Advil, Motrin) for pain. Talk to your doctor first to find out what medications are safe for your child.
- Apply an antibiotic ointment, such as Neosporin or Bacitracin, to the tip of the penis twice a day for at least two weeks.
- Make a warm bath for your child to sit in to relieve pain 24 hours after the procedure is done.
- Don’t use wipes when changing your child’s diaper. Use a warm, damp cloth instead.
- Don’t let your child do any strenuous physical activity for at least a week.
- If instructed, insert a lubricated dilator into the meatus two times a day for six weeks to keep it from narrowing.
Are there any risks associated with this procedure?
Meatotomy is considered a safe procedure. Your child may have some of the following symptoms for a few weeks afterwards:
- 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
How effective is this procedure?
Meatotomy is an effective treatment if your child has a narrow or blocked meatus that’s keeping them from peeing normally. Most children who have this procedure have an excellent outlook and only rarely need any follow-up treatment for complications or additional follow-up surgeries.