eMedicine Specialties > Pediatrics: Surgery > Urology

Meatal Stenosis: Differential Diagnoses & Workup

Author: Carlos A Angel, MD, Associate Professor of Pediatrics, Division of Pediatric Surgery, University of Tennessee School of Medicine; Consulting Staff, East Tennessee Children's Hospital, East Tennessee Pediatric Surgery Group
Contributor Information and Disclosures

Updated: Oct 1, 2009

Differential Diagnoses

Circumcision

Other Problems to Be Considered

Meatal stenosis is often missed as a complication of circumcision because boys do not receive long-term follow-up care after this procedure.

Symptoms of meatal stenosis are often mistaken for urinary tract infections and, unfortunately, are treated empirically with antibiotics.

Impairment to distal urethral urinary flow may be ignored or may go unrecognized for months until caregivers happen to witness the child with meatal stenosis void.

Workup

Laboratory Studies

Meatal stenosis does not cause urinary tract infections, hydronephrosis, or any form of obstruction of the lower urinary tract. For this reason, no further urological investigation is warranted. If the diagnosis is in question, observing the child void, with particular attention to the force of the stream (increased), caliber of the stream (decreased), and duration of the voiding episode (usually prolonged), is helpful. If an elimination disorder is suspected, noninvasive urodynamics such as uroflow with electromyography (pad electrodes) and measurement of bladder capacity and postvoid residuals could be indicated. If associated infection is a possibility, urinalysis with culture should be obtained.

More on Meatal Stenosis

Overview: Meatal Stenosis
Differential Diagnoses & Workup: Meatal Stenosis
Treatment & Medication: Meatal Stenosis
Follow-up: Meatal Stenosis
References
[ CLOSE WINDOW ]

References

  1. Van Howe RS. Incidence of meatal stenosis following neonatal circumcision in a primary care setting. Clin Pediatr (Phila). Jan-Feb 2006;45(1):49-54. [Medline].

  2. Litvak AS, Morris JA, McRoberts JW. Normal size of the urethral meatus in boys. J Urol. Jun 1976;115(6):736-7. [Medline].

  3. Gargollo PC, Kozakewich HP, Bauer SB, et al. Balanitis xerotica obliterans in boys. J Urol. Oct 2005;174(4 Pt 1):1409-12. [Medline].

  4. Brown MR, Cartwright PC, Snow BW. Common office problems in pediatric urology and gynecology. Pediatr Clin North Am. Oct 1997;44(5):1091-115. [Medline].

  5. Smith C, Smith DP. Office pediatric urologic procedures from a parental perspective. Urology. Feb 2000;55(2):272-6. [Medline].

  6. Frank JD, Pocock RD, Stower MJ. Urethral strictures in childhood. Br J Urol. Dec 1988;62(6):590-2. [Medline].

  7. Garat JM, Chechile G, Algaba F, Santaularia JM. Balanitis xerotica obliterans in children. J Urol. Aug 1986;136(2):436-7. [Medline].

  8. Persad R, Sharma S, McTavish J, et al. Clinical presentation and pathophysiology of meatal stenosis following circumcision. Br J Urol. Jan 1995;75(1):91-3. [Medline].

  9. Sijstermans K, Hack WW, Bos SD, van der Horst HJ. [Urethral meatal stenosis in boys easily overlooked]. Ned Tijdschr Geneeskd. Dec 10 2005;149(50):2765-9. [Medline].

  10. Stenram A, Malmfors G, Okmian L. Circumcision for phimosis: a follow-up study. Scand J Urol Nephrol. 1986;20(2):89-92. [Medline].

[ CLOSE WINDOW ]

Further Reading

[ CLOSE WINDOW ]

Keywords

meatal stenosis, circumcision, circumcision complication, meatus, meatotomy

[ CLOSE WINDOW ]

Contributor Information and Disclosures

Author

Carlos A Angel, MD, Associate Professor of Pediatrics, Division of Pediatric Surgery, University of Tennessee School of Medicine; Consulting Staff, East Tennessee Children's Hospital, East Tennessee Pediatric Surgery Group
Carlos A Angel, MD is a member of the following medical societies: American College of Surgeons, American Pediatric Surgical Association, British Association of Paediatric Surgeons, Children's Oncology Group, International Children's Continence Society, International Pediatric Endosurgery Group, New York Academy of Sciences, Society of Critical Care Medicine, and Texas Pediatric Society
Disclosure: Nothing to disclose.

Medical Editor

Howard M Snyder III, MD, Professor, Department of Surgery, Division of Pediatric Urology, University of Pennsylvania School of Medicine
Howard M Snyder III, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, American Medical Association, American Urological Association, and National Kidney Foundation
Disclosure: Nothing to disclose.

Pharmacy Editor

Mary L Windle, PharmD, Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy, Pharmacy Editor, eMedicine
Disclosure: Pfizer Inc Stock Investment from financial planner; Avanir Pharma Stock Investment from financial planner ; WebMD Salary and stock Employment and investment from financial planner

Managing Editor

Harry P Koo, MD, Chairman of Urology Division and Director of Pediatric Urology, Virginia Commonwealth University; Professor of Surgery, VCU School of Medicine, Medical College of Virginia; Director of Urology, Children's Hospital of Richmond
Harry P Koo, MD is a member of the following medical societies: American Academy of Pediatrics, American College of Surgeons, and American Urological Association
Disclosure: Nothing to disclose.

CME Editor

Daniel Rauch, MD, FAAP, Director, Pediatric Hospitalist Program, Associate Professor, Department of Pediatrics, New York University School of Medicine
Daniel Rauch, MD, FAAP is a member of the following medical societies: Ambulatory Pediatric Association, American Academy of Pediatrics, and Society of Hospital Medicine
Disclosure: Baxter Honoraria Consulting

Chief Editor

Marc Cendron, MD, Associate Professor of Surgery, Harvard School of Medicine; Consulting Staff, Department of Urological Surgery, Children's Hospital Boston
Marc Cendron, MD is a member of the following medical societies: American Academy of Pediatrics, American Urological Association, European Society for Paediatric Urology, Johns Hopkins Medical and Surgical Association, New Hampshire Medical Society, Society for Fetal Urology, and Society for Pediatric Urology
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.