Meatoplasty / Meatotomy
Surgical Widening of the Urethral Meatus to Improve Urinary Flow
What is Meatoplasty / Meatotomy?
Meatoplasty and Meatotomy are procedures to widen a narrowed or stenotic urethral meatus (external urethral opening). Meatotomy involves a simple incision of the meatal stenosis, while Meatoplasty involves formal reconstruction of the meatus using local tissue to create a wider, cosmetically acceptable opening. These procedures are performed for symptomatic meatal stenosis causing obstructive voiding, urinary retention, or recurrent UTIs. The procedure is performed under general or spinal anaesthesia with a hospital stay of Day Care. Success rates reach >85% in appropriately selected patients at experienced centres.
How the Procedure Works
Assessment Under Anaesthesia
Under local or general anaesthesia, the penis is examined and the meatus assessed for degree of stenosis.
Meatoplasty — Formal Reconstruction
For meatoplasty: the edges of the dorsal meatal incision are sutured with fine (6-0 absorbable) sutures to create a wide, durable meatus.
Meatotomy — Simple Incision
For meatotomy: after the meatal incision is made, the raw edges are left to heal by secondary intention.
Distal Stricture Extension
For distal strictures extending into the penile urethra: the urethrotomy is extended proximally along the urethra.
Post-Op Care
Post-operative care involves meatal dilations with a glass or plastic rod or appropriately sized catheter daily for several weeks.
Outcomes
Who Needs This Treatment?
- →Meatal stenosis is the most common cause of distal urethral obstruction.
- →Meatotomy (simple dorsal incision) has a significant recurrence rate — formal meatoplasty is preferred.
- →Balanitis xerotica obliterans (BXO/lichen sclerosus) is a common cause requiring circumcision alongside meatoplasty.
- →The adult male meatus should comfortably accept a 16 Fr catheter — calibration confirms adequacy.
- →Post-operative self-dilation with a meatal dilator prevents re-stenosis after meatotomy.
- →Meatoplasty is a short procedure typically lasting 15–30 minutes with same-day discharge.
"Meatal stenosis is easily overlooked but greatly impacts quality of life. A well-performed meatoplasty restores a normal stream and eliminates the cycle of infection and retention it causes."
— — Dr. Vipin Reddy, Consultant Urologist, Andrologist & Renal Transplant Surgeon
Common Questions
Frequently Asked
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