Meatotomy Surgery

The urethra and the opening of the urethra (urinary meatus) are structures through which urine passes on its way out of the body, after accumulating in the urinary bladder. The emptying of the bladder and the exit of urine from the body in a normal manner are of great importance, as the accumulation of urine in the body can cause many health problems, including problems considered to be life-threatening in their advanced stages.

Occasionally, for reasons not yet fully understood, the urethra can become partially or completely blocked, making normal emptying very difficult. In many cases, this occurs in young infants, a fact that makes diagnosis more difficult. Practically speaking, when the blockage is partial, it might be discovered only at two-three years of age, when the child is toilet-trained.

Narrowing of the urethra occurs at a relatively high rate among circumcised boys (3-10%), although it has not been proved to date that the circumcision itself or the technique employed by the person performing the circumcision are the direct cause of the narrowing. One hypothesis is that the friction between the tip of the foreskin-less penis and the wet diaper causes scarring of tissue in the circumcised area – scarring that narrows the urethral opening.

Whatever the cause may be, narrowing of the urethra is a condition that needs to be treated, both in order to prevent discomfort, and more importantly – in order to prevent a situation in which urine accumulates in the body and proper emptying is not possible, which could cause various effects, from the development of infections to kidney failure. Even if all these effects are not considered, it should be remembered that narrowing of the urethra causes pain while urinating, and sometimes also a high frequency of urination.

General information about the procedure

Widening a narrowed urethra is quite a simple procedure, performed even on small infants as soon as the problem is identified and properly diagnosed. Naturally, it can also be performed in older children and even adults. There have recently been more and more cases of women treated for the narrowed urethra, but this is still considered to be very rare.

An operation to widen a narrowed urethra includes one main procedure – broadening of the urethra by a few millimeters, by careful cutting in the region. After that, an ointment will be applied to the urethral opening, helping to maintain the situation achieved after the operation.

Preparing for the procedure

The patient will need to undergo a blood test and provide a urine specimen prior to the operation. If the operation is performed under general anesthesia, a few hours of fasting are required beforehand.

The course of the procedure

If the patient is an infant, the operation to widen the narrowed urethra will be performed under general anesthesia. In the case of an adult patient, it is possible that only local anesthesia will be required, and occasionally, the operation will be performed with the patient under the influence of laughing gas only.

As stated above, an operation to widen a narrowed urethra includes one main procedure: broadening of the urethra by a few millimeters by careful cutting. While the blockage appears significant during attempts to urinate, usually, all that is needed to widen the urethra to the desired dimensions is only a few extra millimeters. The entire procedure takes up to 20 minutes.

After the cut is made, ointment will be applied to the site of the operation (this will usually be an eye ointment called synthomycine), which should also be applied to the site of the operation for a few days afterwards. Spreading open the urethral opening in order to apply the ointment, and applying the ointment itself, will ensure that the tissue does not scar again and that the urethral opening does not become narrow again.

In the first few days after the operation, it is important to keep the place clean (washing with water and soap will suffice). In the case of an infant, it is necessary to monitor how he urinates and to check that the condition has improved.

Side Effects

An operation to widen a narrowed urethra is quite simple. It should therefore not cause problems. Nevertheless, even this operation is not risk-free, since it is a surgical procedure, and there are some effects that it could cause: nausea, vomiting, and headaches in the case of general anesthesia; bleeding and infection at the site of the operation; excessively broadened urethra.