Meatotomy
A meatotomy is a medical procedure involving the surgical incision of the urethra's meatus, typically to enlarge it. This procedure is often performed to address conditions that restrict the urethral opening, such as meatal stenosis, which can cause difficulty in urination and increased risk of urinary tract infections. Meatotomy can be considered a form of urethral dilation and is a relatively straightforward outpatient procedure.
Indications
The primary indication for a meatotomy is meatal stenosis or any condition that results in the narrowing of the urethral meatus. Symptoms that might necessitate a meatotomy include difficulty urinating, a weak urine stream, pain during urination, and recurrent urinary tract infections. Conditions like hypospadias or previous surgeries on the penis or urethra can also lead to complications requiring a meatotomy.
Procedure
A meatotomy is typically performed under local anesthesia in an outpatient setting. The process involves making a small incision at the tip of the penis on the underside of the meatus to widen the urethral opening. The incision's length depends on the degree of stenosis. After the incision, the edges are often left unstitched, allowing them to heal and form a wider opening naturally. Post-operative care includes keeping the area clean, applying antibiotic ointment, and avoiding activities that might irritate the urethra.
Risks and Complications
As with any surgical procedure, meatotomy carries potential risks and complications, though they are relatively rare. These can include bleeding, infection, meatal regression or the need for further surgery, and changes in the urine stream direction. Long-term complications are uncommon but can include urethral stricture or fistula formation.
Recovery
Recovery from a meatotomy is generally quick, with most individuals able to resume normal activities within a few days. Pain and discomfort should be minimal and can be managed with over-the-counter pain relievers. It is important to follow the surgeon's post-operative care instructions closely to ensure proper healing and reduce the risk of complications.
Conclusion
A meatotomy is a safe and effective procedure for treating meatal stenosis and other conditions that cause narrowing of the urethral opening. It can significantly improve the quality of life for individuals experiencing symptoms related to urethral narrowing. As with any medical procedure, individuals considering a meatotomy should discuss the potential risks and benefits with their healthcare provider.
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Contributors: Prab R. Tumpati, MD