Name of the Procedure:

Meatotomy (cutting of meatus); except infant

Summary

Meatotomy is a surgical procedure that involves making an incision to enlarge the opening of the urethra, known as the meatus. It is typically performed to address issues related to a narrowing or blockage of this opening.

Purpose

The purpose of the meatotomy is to relieve urinary flow problems by widening the urethral opening. This can help reduce symptoms such as difficulty urinating, a weak urine stream, or recurrent urinary tract infections.

Indications

• Meatal stenosis (narrowing of the urethral opening)
• Recurrent urinary tract infections
• Difficulty urinating or painful urination
• Previous unsuccessful treatments for urethral narrowing

Preparation

• Fasting for a few hours before the procedure if general anesthesia is used.
• Temporary adjustment or discontinuation of certain medications, as instructed by the healthcare provider.
• Preoperative assessments including urinalysis or urine culture to rule out infections.

Procedure Description

1. The patient is positioned appropriately, and the genital area is cleaned and sterilized.
2. Local anesthesia or light sedation may be applied to numb the area.
3. The surgeon makes a small incision at the tip of the urethra to widen the meatus.
4. The incision site might be sutured or left to heal naturally, based on the surgeon's approach.
5. The procedure is often quick and minimally invasive.

Tools: Surgical scalpel, sutures (if needed), local anesthetic.

Duration

The procedure typically takes about 15 to 30 minutes.

Setting

Meatotomy can be performed in a hospital operating room, outpatient surgical center, or specialized clinic.

Personnel

• Urologist (surgeon)
• Nurse or surgical assistant
• Anesthesiologist or nurse anesthetist (if sedation or general anesthesia is used)

Risks and Complications

• Bleeding or infection at the incision site
• Pain or discomfort during healing
• Rarely, recurrence of meatal stenosis
• Possibility of an altered urine stream
• Scarring or strictures over time

Benefits

• Improved urinary flow
• Reduction in symptoms such as pain or difficulty urinating
• Decreased risk of recurrent urinary tract infections Results are often noticeable shortly after recovery from the procedure.

Recovery

• Patients may go home the same day.
• Pain relief measures, such as over-the-counter pain medication.
• Keeping the area clean and dry to avoid infection.
• Avoiding strenuous activities for a few days.
• Follow-up appointment to monitor healing and ensure no recurrence of symptoms.

Alternatives

• Dilation: Temporary widening of the meatus using dilators.
• Urethrotomy: Internal incision to remove blockage within the urethra.
• Topical medications: less invasive but typically less effective for severe cases.

Patient Experience

• Mild discomfort or stinging sensation during urination for a few days.
• Post-procedure pain is generally manageable with over-the-counter medication.
• Patients may notice an immediate improvement in urinary flow.
• Detailed instructions from the healthcare provider to ensure a smooth recovery.