Meatal stenosis...one in ten!

[mamakay]

http://www.emedicine.com/ped/topic2356.htm

I was just reading the usual procirc argument that "circumscision complications are rare"...
So I decided to look up the "official rate" of meatal stenosis.
10%?
That is NOT rare!
That is extremely common!
And getting it "fixed" is horribly traumatic....my poor dh had to have a small surgery done in the peds office when he was 3 for this, and he still feels sick thinking about it.

[AntoninBeGonin]

Thanks for the link.

Sorry about your poor Dh.

~Nay

[Leiahs]

That is shockingly common!!

I have a question, now, however. I have been reading repeatedly on these forums that meatal stenosis is *exclusively* a problem for circumcised children. This link says differently.

It does say

Because this condition is exceedingly rare in children who are not circumcised, circumcision is believed to be the most important causative factor of meatal stenosis.

but also says

Other causes of meatal stenosis include the following:
-Unsuccessful hypospadias repair
-Trauma
-Prolonged catheterization
-Balanitis xerotica obliterans (BXO), which is an unusual condition that causes a whitish discoloration and dry appearance of the glans, can also cause meatal stenosis.
-In children with BXO, meatal stenosis seems to be quite frequent.
Although BXO is difficult to treat, meatotomy yields good results in patients with BXO.

So from this it sounds like although very very very rare, meatal stenosis can actually occur in an intact male. Is this correct? Can someone comment?

[Bm31]

Yes, I think it is very common. Nobody explained it to me at the time, but I'm pretty sure this is what I had very shortly after my re-circ at the age of 6. My urine stream became very narrow, though I don't remember it being painful. What WAS painful was when the urologist gave me a little local and cut a new hole right in his office on a follow-up visit for the circ.

I never even really thought about this much before, but I wonder if he even did that right. Maybe somebody here would know if it's normal in a meatotomy to cut a new hole. Why not enlarge the existing one? It was where I think one should have been, the farthest "point" out on my penis. The new one was partway down the underside of the head of my penis. Isn't that what they try to fix with hypospadias??? The two streams came out together when I urinated into a conjoined spray for a while until finally the original hole closed up. Nothing that doctor did makes much sense to me.

[Frankly Speaking]

Originally Posted by mamakay

http://www.emedicine.com/ped/topic2356.htm

I was just reading the usual procirc argument that "circumscision complications are rare"...
So I decided to look up the "official rate" of meatal stenosis.
10%?
That is NOT rare!
That is extremely common!
And getting it "fixed" is horribly traumatic....my poor dh had to have a small surgery done in the peds office when he was 3 for this, and he still feels sick thinking about it.

There have been studies that find a range of between 9% and 31% and Dr. Paul Fleiss who is very knowledgeable has said he sees evidence of meatal stenosis in 60% of his circumcised patients.

The personal accounts of the surgery describe it as extremely painful, so I have no doubt about your husband's experience being accurate.



Frank

[Frankly Speaking]

Originally Posted by Leiahs

So from this it sounds like although very very very rare, meatal stenosis can actually occur in an intact male. Is this correct? Can someone comment?

It does appear so. I was just presented with this a few weeks ago but if you'll notice, the common thread in the intact boys is that there was trauma, either physical or pathogenic in those cases and there lies the explaination. I think it is still legitimate to say meatal stenosis is a complication of circumcision. After 5 years in this issue, I have never heard of a single case of meatal stenosis in an intact child and probably a hundred cases in circumcised boys. Other than mis-diagnoses of phimosis, it's probably the most common thing we see. It would be extremely rare.



Frank

[Frankly Speaking]

Originally Posted by Bm31

Yes, I think it is very common. Nobody explained it to me at the time, but I'm pretty sure this is what I had very shortly after my re-circ at the age of 6. My urine stream became very narrow, though I don't remember it being painful. What WAS painful was when the urologist gave me a little local and cut a new hole right in his office on a follow-up visit for the circ.

The procedure was a meatotomy and it is for the resolution of meatal stenosis. Your symptoms point toward meatal stenosis. Often, a long lasting symptom of meatal stenosis is a very firm area around the meatus. I have that, so I assume that I had some degree of meatal stenosis at some time although I don't remember any procedure to resolve it.

I never even really thought about this much before, but I wonder if he even did that right. Maybe somebody here would know if it's normal in a meatotomy to cut a new hole. Why not enlarge the existing one? It was where I think one should have been, the farthest "point" out on my penis. The new one was partway down the underside of the head of my penis. Isn't that what they try to fix with hypospadias??? The two streams came out together when I urinated into a conjoined spray for a while until finally the original hole closed up. Nothing that doctor did makes much sense to me.

It sounds like you had a case of iatrogenic hypospadias. That is, a case caused by a doctor. The meatus should be at the very tip of the penis. I have no idea why he cut a new one unless he thought that if he cut the old one back open that it would only close again and require another procedure.



Frank

[daekini]

Originally Posted by Bm31

Yes, I think it is very common. Nobody explained it to me at the time, but I'm pretty sure this is what I had very shortly after my re-circ at the age of 6. My urine stream became very narrow, though I don't remember it being painful. What WAS painful was when the urologist gave me a little local and cut a new hole right in his office on a follow-up visit for the circ.

I never even really thought about this much before, but I wonder if he even did that right. Maybe somebody here would know if it's normal in a meatotomy to cut a new hole. Why not enlarge the existing one? It was where I think one should have been, the farthest "point" out on my penis. The new one was partway down the underside of the head of my penis. Isn't that what they try to fix with hypospadias??? The two streams came out together when I urinated into a conjoined spray for a while until finally the original hole closed up. Nothing that doctor did makes much sense to me.

this makes me sad
my dh had his corrected when he was in the 2nd grade (in an earlier post I think I said at age 4 but we've learned that is was actually when he was 7) and it was pretty traumatic, he still has a great deal of trouble urinating.

His doc did make the original opening larger - Bm31 your physician's decision sounds very weird but maybe there was some reason for it. I would hope that he didn't do that simply because he was an idiot.

[Bm31]

Originally Posted by daekini

this makes me sad
my dh had his corrected when he was in the 2nd grade (in an earlier post I think I said at age 4 but we've learned that is was actually when he was 7) and it was pretty traumatic, he still has a great deal of trouble urinating.

His doc did make the original opening larger - Bm31 your physician's decision sounds very weird but maybe there was some reason for it. I would hope that he didn't do that simply because he was an idiot.

I don't know if he was an idiot, but between his workmanship on the circ and this deal I've come to think of him as a sort of Dr. Mengele. :

Thanks for your input about your dh's meatotomy. Maybe Frank's suggestion is right and the original would be more likely to close again. I can't say I really have any trouble urinating. It did spray pretty erratic before the original hole totally closed, and to this day it seems like the trajectory can still be unreliable, though.

I really don't know what else to think about it. My mother had ZERO recall of the whole thing because it happened on an appointment that my grandmother took me to, and she's dead now.