What is a stenosis of the urinary meatus?
The urethra begins at the lower end of the bladder and opens into the glans in men, and above the vagina in women. In women, the urethra is much shorter (about 4 cm) than in men (about 20 cm). A narrowing of the urethra in its course, is thus more likely to occur in men than women. Stenosis of the urethral meatus is a narrowing of the urethra, at its opening. It is categorized as a mild illness, but it is nonetheless an uncomfortable condition.
- An Ativan may be offered an hour before the procedure to help calm the person.
- Anti-coagulant drugs should be stopped a few days before the procedure. Aspirin treatment can sometimes be continued at a low dose.
- To prevent infection, you may be given a dose of antibiotics before the procedure
- Avoid physical exertion for seven days.
- Resumption of activity is usually rapid (within a few days).
- Sexual activities can be resumed after seven days.
- A post-operative follow-up will be done within four to 12 weeks; follow-up consists of evaluating the improvement in urinary symptoms and the good quality of the bladder emptying. Recurrences are unfortunately frequent.
- In the event of recurrence, home self-dilation is sometimes offered.
What are the causes for a urethral stenosis ?
- Urinary tract infection (eg. gonorrhea)
- Infection of foreskin (glans)
- Tumor of the urethra (very rare)
- Atrophic skin disease (eg lichen sclerosus)
- Technical manipulations such as catheterization, endoscopy, certain sexual practices with foreign bodies: the trauma caused can lead to the formation of scars and consequently to narrowing of the urethra
- A complication of circumcision in children
- Complication of prostate surgery or other operations on the urinary tract.
What are the symptoms of a urethral stenosis?
- Very fine and/or intermittent urinary stream
- Post-voiding drops
- Urinary infection
- Burning sensation during urination
- Blood in the urine (hematuria)
- Difficulty emptying the bladder completely
How to diagnose stenosis of the urethral meatus?
- A good comprehension of the patient's symptoms
- Questions about the history of infections and trauma
- An examination of the glans (this may allow to visualize a narrowing of the urinary meatus)
- Urinary analysisi or culture
- Bladder ultrasound (may detect the presence of residual urine and determine the state of the bladder)
- Endoscopy of the urethra (cystoscopy)
What are the possible treatments for urinary tract stenosis?
• Dilation of the urethral meatus
• Meatotomy or Meatoplasty
What can we expect after treatment of stenosis?
After the meatotomy, analgesics and hot baths can be taken to reduce discomfort. Bleeding is not common, but if present, can usually be controlled by putting pressure on the dressing (on the operated area). The recovery time is about one to two days, but applying vaseline or ointment to the surgical area several times a day for one to two weeks, can help the wound heal faster.
What are the possible complications of untreated stenosis?
There is a wide variety of opinions about the effects of untreated urethral stenosis on the health of the urinary system. Some researchers believe that this disease can lead to urinary tract infections, kidney problems, involuntary urination or even urine reflux. Others doubt that these problems may result from stenosis alone and warn against a meatotomy based solely on the appearance of the meatus.