Have you noticed anything strange when your little one urinates ? Maybe the urine doesn't go straight, but instead flows from side to side, or does it feel like it hurts when he urinates ? It's normal for a parent to feel a little scared when they see these things. But don't worry. Today we're talking about a condition called 'Meatal Stenosis' that can cause this and a minor surgery to treat it.
Simply put, what is Meatoplasty?
Meatoplasty is a surgical procedure that enlarges the urethral meatus, the opening at the tip of a boy's penis. This opening is at the end of the urethra. Urine comes out of this opening.
But you may have also heard of a meatotomy. The two are very similar. In a meatoplasty, the surgeon makes a small incision at the tip of the penis and reshapes the opening, sometimes with stitches. A meatotomy is a bit simpler. It just widens the opening, and in most cases, no stitches are used. However, many people use these two terms interchangeably.
What is the reason for this surgery? (Meatal Stenosis)
This surgery is mainly done to treat a condition called meatal stenosis, which is a very narrow opening in the urethra. This can be congenital in some children. However, it usually develops between the ages of 3 and 7. It is especially common in boys who have been circumcised.
If you suspect that your son has this condition, be a little concerned about these symptoms.
| Symptom | Description |
|---|---|
| Difficulty urinating | The child has difficulty urinating straight. The urine flows upward or to the side. |
| The nature of the urinary tract | A very thin, rapid stream of urine or spraying in one direction. |
| Frequent urination | Needing to urinate more often than usual. |
| Pain or inflammation | Feeling pain or burning when urinating. |
In addition, this surgery is sometimes performed on children with a mild form of the birth defect called hypospadias.
Why does the urethral opening narrow like this?
The main reason for this is the fine wounds and scars that form on the tip of the penis. There are several possible reasons for this:
- Circumcision: The fine scars that appear after surgery to remove the foreskin of the penis.
- Diaper rash: Imagine, when a baby is wearing a diaper, the tip of his penis rubs against the diaper constantly. The tiny wounds caused by this rubbing can turn into scars.
- Use of urinary catheters: If a urinary catheter is left in place for a long time due to a medical condition, that can also be a cause.
How do you prepare before surgery?
First, you need to take your son to a doctor. The doctor will check the child's general health. In addition,
- You can examine your son's penis and measure the width of the urethral opening.
- They ask you questions. For example, things like which way does the urine go and whether it is peeing.
- You may also be able to watch the child urinate and measure the flow rate.
The most important thing: There are a few things you need to tell your doctor. Be sure to tell him if your son has any bleeding disorders , any allergies to any medications , and what medications he is taking . Some medications, such as NSAIDs, can increase the risk of bleeding during surgery.
As a parent, it is very important for you to remain calm. Even if your children cannot understand your words, they can sense your behavior and facial expressions. If you remain calm, your son will also be unafraid.
How is the surgery done?
This is a very simple surgery that usually takes less than an hour.
1. Numbness and Anesthesia: First, a nurse cleans the boy's penis and applies a numbing cream. Then, the anesthesiologist puts the boy completely to sleep. So, the boy doesn't feel any pain during the surgery.
2. Surgery: After the child is well asleep, the surgeon (Pediatric Urologist) makes a small 'V'-shaped incision on the underside of the penis, below the urethral opening, to widen the opening.
3. Stitches or glue: After that, a special type of surgical glue or dissolvable stitches are used to heal the wound.
After this surgery, the child can go home the same day. After the child wakes up, the nurses take good care of him.
How to take care of the child after surgery?
The first week after surgery is very important. Give your child some rest. He may sleep more than usual, which will help him recover.
- Pain: There may be some burning or pain when urinating for about a week or two. You can take a painkiller like Paracetamol as prescribed by your doctor.
- Ointments: Apply an antiseptic ointment or something like Vaseline prescribed by your doctor to the tip of the penis about three times a day.
- Cleanliness: Change your baby's diapers regularly. If possible, leave your baby without diapers for a few hours a day. When bathing your baby, gently wash the area with soap and water, and gently pat dry.
- Play: Avoid toys that require you to swing your legs from side to side, such as bicycles, rocking horses, and swings, for at least a week. It's best to limit your child's running and jumping to a few games.
Risk situations and when to go to the hospital immediately
Although this is a very safe procedure, there are some risks with any surgery. Bleeding, infection, and scarring are very rare.
However, if you notice any of the following symptoms, take your child to the nearest Emergency Department (ETU) as soon as possible.
| Emergency Signs | |
|---|---|
| 🌡️ | Having a fever of 100 Fahrenheit (38 Celsius) or higher. |
| 🩸 | Having heavy bleeding that doesn't stop. |
| 😫 | The pain is getting worse. |
| 🤢 | Vomiting more than three times a day. |
| 🚽 | Severe difficulty urinating or the child's diaper is always dry. |
Take-Home Message
- Meatal stenosis is a common condition seen in boys. Don't be unnecessarily alarmed by this.
- Meatoplasty is a very safe, successful, and simple surgery for this.
- It is very important to give the child good rest after the surgery and to follow the doctor's instructions exactly.
- If you notice any unusual symptoms during your child's recovery, don't delay in informing the doctor.
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