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Clinical presentation and pathophysiology of meatal stenosis following circumcision
R Persad1, S Sharma, J McTavish
1Department of Paediatric Urology, Addenbrooke's Hospital, Cambridge, UK.
Insights
Meatal stenosis, a narrowing of the urethral opening, can occur after infant circumcision. Surgical correction with meatotomy is effective, and preserving the frenular artery during circumcision may prevent this complication.
Area of Science:
- Pediatric Urology
- Surgical Complications
Background:
- Meatal stenosis is a potential complication following infant circumcision.
- Understanding its clinical presentation and pathophysiology is crucial for prevention and management.
Purpose of the Study:
- To describe the clinical presentation and pathophysiology of meatal stenosis after circumcision.
- To identify potential causes and preventive strategies.
Main Methods:
- Retrospective review of 12 children with meatal stenosis over 3 years.
- Clinical presentation and operative findings were analyzed.
Main Results:
- Common symptoms include penile pain during urination, a narrow urinary stream, and altered voiding posture.
- Surgical meatotomy resolved stenosis with no recurrence after a mean 13-month follow-up.
- Possible causes include traumatic meatitis or damage to the frenular artery during circumcision.
Conclusions:
- Meatal stenosis after circumcision is characterized by specific voiding symptoms.
- Meatotomy is an effective surgical treatment.
- Preserving the frenular artery or considering alternative procedures like preputial plasty may prevent meatal stenosis.
Objective:
To describe the clinical presentation and pathophysiology of meatal stenosis occurring after circumcision.
Patients And Methods:
The clinical presentation and operative findings are reported in 12 children who presented with meatal stenosis over a period of 3 years.
Results:
The cardinal symptoms of meatal stenosis were penile pain at the initiation of micturition (12 of 12), narrow, high velocity stream (8 of 12) and the need to sit or stand back from the toilet bowl to urinate (6 of 12). Following surgical correction with meatotomy there was no recurrence of stenosis after a mean follow-up of 13 months. Traumatic meatitis of the unprotected post-circumcision urethral meatus and/or meatal ischaemia following damage to the frenular artery at circumcision are suggested as possible causes of meatal stenosis.
Conclusion:
Preservation of the frenular artery at circumcision, or the use of an alternative procedure (preputial plasty), may be advisable when foreskin surgery is required, to avoid meatal stenosis after circumcision.