Meatotomy

Frequent inflammatory processes of the genitourinary system in men, circumcision (especially if not performed professionally), catheterization or injury to the genital organ can be complicated by narrowing of the urethra (meatostenosis). Most often, such pathology is localized in its distal part. A narrowed urethral outlet can be a congenital defect or acquired for various reasons already at a very tender age. Such pathology leads to overload of the bladder, stagnation of urine, and negatively affects the functioning of the kidneys. Meatotomy - surgical expansion of the external opening of the urethra, is the most effective way to get rid of this problem.

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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.

Meatotomy is also indicated for patients diagnosed with anterior hypospadias with a slight deviation from the normal position of the meatus, meatostenosis.

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Preparation

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

As part of the preoperative examination, the patient will undergo blood tests: clinical, glucose content, biochemical composition, coagulation, blood group and Rh factor, the presence of syphilis, hepatitis B and C, HIV infection. Beforehand, he will undergo fluorography and electrocardiography. A therapist or pediatrician will assess the patient's general health.

The list of pre-operative examinations may be expanded depending on whether the patient has chronic diseases.

The patient will talk to the anesthesiologist and will be warned that since the operation is performed under anesthesia, to avoid asphyxiation from vomit, they should not eat or drink for the next eight hours. Adult patients are advised to remove pubic hair immediately before the operation.

Technique meatotomies

Urethral meatotomy in adult men and older boys is performed under general anesthesia (local anesthesia is undesirable as it leads to swelling and cutting of suture threads).

The surgical intervention is performed as follows: a scalpel, regular or laser, is inserted into the urethra, and it is cut to the required size. Advantages of the laser: no contact with the skin, i.e. no pressure on the tissue and risk of infection, seals the vessels, preventing bleeding, pain and swelling.

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

The bleeding is stopped and the mucous membrane of the urethra is sutured with self-dissolving threads to 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 bandage is applied.

In infancy, meatotomy is performed without suturing. In this case, a thin clamp is inserted into the urethral opening, the tissues crushed by it are cut with surgical scissors. The cut edges are spread apart, lubricated with antiseptic ointment or sterile petroleum jelly to prevent them from joining together and growing together in the same position.

Meatotomy is not performed at home. The operation must be performed in a sterile operating room by a qualified urological surgeon.

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Contraindications to the procedure

He should not have any mental illnesses, a tendency to bleeding, genitourinary diseases, malignant tumors or diabetes.

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

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Consequences after the procedure

This surgical intervention is considered minimally invasive; adverse effects after it, if the doctor’s recommendations are followed, occur rarely and mainly in unscrupulous patients.

Failure to comply with the rules of postoperative behavior can provoke complications after the procedure - bleeding, infection and inflammation.

Pain after meatotomy in men, fever, suppuration, bleeding should be a reason to see a doctor.

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

Problems with ejaculation and urination after surgery are complications. If the stream sprays after meatotomy, you should also consult a doctor. This should not happen. This is a symptom of glans hypospadias, which must be eliminated by surgery.

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Care after the procedure

After the surgical manipulation, infants are left under the supervision of doctors until the general condition of the body stabilizes. This usually happens within a few hours, after which they are discharged with a 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. Most often, patients go home on the day of the operation, sometimes they are detained for a couple of days. The catheter is removed after a day or two, the stitches dissolve within ten days and the surgical wound heals.

The patient is kept under the supervision of a urologist for up to three months with periodic monitoring of the size of the external opening of the urethra.

Until complete healing, activities that involve increased physical exertion and sexual intercourse are not recommended.

Life after meatotomy should improve qualitatively. The operation is not complicated, recovery is fast, problems with urination and their accompanying, as a rule, are eliminated.

Reviews of meatotomy are positive, complications are almost non-existent, healing occurs quickly, especially when using laser technologies.