Meatal stenosis is one of the more common complications that can occur in a male following circumcision. The diagnosis may be made years after the procedure.
Meatal stenosis is defined (Upadhyay et al):
(1) change in the delicate lips of the urethral meatus
(2) loss of elliptical shape due to fibrosis or scarring
(3) visibly apparent narrowing of the opening
The patient may be asymptomatic or symptomatic with:
(1) penile pain on the start of urination
(2) narrow, high velocity urine stream
(3) need to sit or to stand back from toilet to urinate
The stenosis may range from asymptomatic with minimal disruption of the urine stream to obstruction of urine flow.
Risk factors:
(1) damage to the frenular artery at circumcision
(2) traumatic meatitis during or after circumcision
(3) urethritis unrelated to circumcision
The designation as being related to circumcision requires exclusion of other causes. It can be useful to review why the circumcision was performed.
More severe degrees of stenosis may require meatotomy to correct.
All males undergoing circumcision should be screened for evidence of meatal stenosis, especially if they have urinary tract or abdominal complaints.
