Meatotomy

Frequent inflammatory processes of the urogenital system in men, circumcision of the foreskin (especially not professionally performed), catheterization or injury to the penis can be complicated by narrowing of the urethra (metostenosis). More often such pathology is localized in its distal part. A narrowed urethral outlet may be a birth defect and acquired for various reasons at the very tender age. This pathology leads to a bladder overload, stagnation of urine, a negative impact on the kidneys. Meatotomy - prompt expansion of the external opening of the urethra, is the most effective way to get rid of this problem.

[1], [2], [3], [4]

Indications for the procedure

The operation is performed at any age in the presence of a narrowing (stricture) of the outlet of a normally located urethra, both congenital and acquired genesis.

Also, the metotomy is indicated by a patient with a diagnosis of “anterior hypospadias with a slight deviation from the normal location of the meatus, metostenosis.”

[5], [6], [7]

Preparation

The preparatory process begins with the consultation of the operating urologist, who will examine the patient and talk with him or his parents about the operation.

In the framework of the preoperative examination, the patient undergoes blood tests: clinical, glucose, biochemical composition, clotting, blood group and Rh factor, the presence of syphilis, hepatitis B and C, HIV infection. Previously, he will do a fluorography and electrocardiography. The therapist or pediatrician will assess the general health of the patient.

The list of studies before the operation can be expanded, based on the presence of a patient of chronic diseases.

The patient will talk with the anesthesiologist, he will be warned that since the operation is performed under general anesthesia, in order to avoid asphyxiation of the vomitus, you should not eat or drink for the next eight hours. Adult patients are advised to remove hair from the pubis immediately before the operation.

Technique of the meatotomies

Urethral meatotomy for adult men and older boys is performed under general anesthesia (local anesthesia is undesirable because it leads to edema and the eruption of suture threads).

Surgical intervention is carried out as follows: a scalpel, normal or laser, is inserted into the urethra, and it is dissected to the required size. The advantages of the laser: no contact with the skin, that is - pressure on the tissue and the risk of infection, sealed blood vessels, preventing bleeding, pain and swelling.

Next is the bougie urethra (to assess its patency) using a Foley catheter or a special metal bougie.

Bleeding stops and the mucous membrane of the urethra is sutured with the skin of the head of the penis, forming the external opening of the urethra.

After this, the surgical field is treated with an antiseptic and a sterile dressing is applied.

In infancy, a metatomy is performed without suturing. At the same time, a thin clamp is inserted into the urethral opening, the tissues crushed by it are dissected with surgical scissors. The cut edges are diluted to the sides, smearing them with an antiseptic ointment or sterile petroleum jelly to prevent joining with each other and splicing in the same position.

Meatotomy at home is not carried out. The operation must be carried out in a sterile environment by a qualified urological surgeon.

[8], [9], [10], [11]

Contraindications to the procedure

It should not have mental illness, bleeding tendency, urogenital diseases, malignant tumors and diabetes mellitus.

The operation is not performed during the period of acute infectious diseases in a patient and / or exacerbation of chronic ones.

[12], [13], [14]

Consequences after the procedure

This surgical intervention refers to minimally invasive, undesirable effects after it, subject to medical recommendations, occur rarely and, mainly, in unscrupulous patients.

Failure to follow the rules of postoperative behavior can provoke complications after the procedure - bleeding, infection and inflammatory processes.

Pain after a maleatomy in men, temperature, suppuration, bleeding should be a reason for seeking medical attention.

Healing after laser metotomy is faster than when performing the operation in the classical way with a scalpel. However, within ten days, signs of recovery should already be well visible with any method of performing the operation. If they are not there, this is a reason to go to a doctor.

Problems with ejaculation and urination after surgery are complications. If the jet is sprayed after a metatomy, then you should also consult a doctor. This should not be. This is a symptom of capitate hypospadias, which should be eliminated precisely by surgery.

[15], [16], [17]

Care after the procedure

After surgical manipulation, babies are left under the supervision of doctors until the general state of the organism is stabilized. This usually occurs within a few hours, after which they are discharged with the recommendation to lubricate the edges of the urethra with an antiseptic ointment so that they do not grow together along the incision line.

The length of hospitalization for adult patients depends on the general condition of the patient and the rules of the medical institution. More often, patients go home on the day of surgery, sometimes they are delayed for a couple of days. The catheter is removed after a day or two, sutures are absorbed within ten days and the wound heals.

The patient is in the dispensary at the urologist for up to three months with periodic monitoring of the size of the external opening of the urethra.

Until complete healing is not recommended exercises, involving increased physical activity, and sexual contacts.

Life after a metotomy should improve qualitatively. The operation is not difficult, recovery occurs quickly, problems with urination and their attendant, as a rule, are eliminated.

Reviews of a metotomy are positive, almost no complications occur, healing occurs quickly, especially when using laser technology.