Meatal stenosis is the narrowing of the meatus or urinary opening. Boys with this problem will often complain of a narrow upward forceful stream. Parents often complain that the boys often "christen" the back of the toilet trying to aim to urinate while standing. This can be threatening to the kidneys by putting backpressure of urine on them while voiding.

Meatal stenosis can often be corrected with a simple office procedure called a meatotomy; a procedure to make the urinary opening bigger. For a meatotomy, the end of your child's penis is numbed with EMLA. EMLA is like a lotion with lidocaine in it. It takes about an hour for the medication to take full effect (and lasts up to three hours). Your doctor may or may not give an additional injection of lidocaine at the time of the procedure. Your child will need to lie very still during the procedure. Parents are welcome to stay in the room with the child. It may be helpful for the child to bring a favorite book or have a present for the child to open at that time. The procedure takes only about 5 minutes, and is usually painless.

The night after the procedure, your child may complain of burning while urinating for the first few times. Please encourage them that it will get better the more often that he goes. You may see some blood spotting on your child's underwear. If your child does bleed just apply some gentle pressure to the area and it should stop. Your child may take a bath the next day after the procedure. He may also feel an evaporative like feeling like menthol that they may consider painful or uncomfortable. If your child is inconsolable (which is rare) you may put them in a bath that night to help soothe the area.

Your job after the procedure is to keep the urinary opening dilated. Your doctor will prescribe an "eye ointment" which acts only as a lubricant. The nozzle on the ointment is just the right size to dilate the opening to keep it from closing again. You should squeeze a small amount of lubricant out on the end of the tube and insert the nozzle up to the hub. Ask your doctor how often and for how long you should do this.

Please feel free to call us with any questions or problems we would be happy to answer them for you.