Name of the Procedure:

Meatotomy (cutting of the meatus); infant

Summary

A meatotomy is a minor surgical procedure performed on infants to cut the meatus (the external opening of the urethra) to widen it. This helps alleviate issues caused by a restricted or narrow meatus.

Purpose

The procedure addresses conditions such as meatal stenosis, where the opening of the urethra is too narrow. The goal is to improve urination by reducing obstruction and preventing associated symptoms like urinary tract infections or discomfort.

Indications

• Symptoms of urinary difficulty or discomfort
• Diagnosis of meatal stenosis
• Recurrent urinary tract infections (UTIs)
• Signs of a narrow urethral opening discovered during a physical examination

Preparation

• Pre-procedure evaluation by a pediatric urologist
• Ensuring the infant is healthy and free from infections
• Following specific feeding instructions prior to the procedure
• Providing caregivers with thorough explanations and post-operative care instructions

Procedure Description

1. Anesthetic cream or a local anesthetic is applied to numb the area.
2. The infant is securely positioned to prevent movement during the procedure.
3. The meatus is cleaned with an antiseptic solution.
4. Using a small surgical knife or scissors, the surgeon makes a precise incision to widen the meatus.
5. Sterile dressings are applied to the area to aid in healing.

Duration

The procedure typically takes around 15-30 minutes.

Setting

Performed in an outpatient clinic or hospital setting, often in a procedure room designed for minor surgeries.

Personnel

• Pediatric urologist or experienced surgeon
• Trained nursing staff
• Anesthesiologist or healthcare provider skilled in administering local anesthesia

Risks and Complications

• Minor bleeding
• Infection at the surgical site
• Scarring or re-narrowing of the meatus
• Discomfort or pain post-procedure

Benefits

• Improved urinary flow and relief of any discomfort
• Reduced risk of urinary tract infections
• Prompt resolution of symptoms following the procedure

Recovery

• Post-procedure instructions for caring for the surgical site (keeping it clean and dry)
• Monitoring for signs of infection or complications
• Follow-up appointments to ensure proper healing
• Typical recovery time is a few days to a week, with minimal restrictions on activity

Alternatives

• Conservative management with periodic dilations (if effective)
• More invasive surgical options for severe cases Pros and cons:
  • Conservative management might be less invasive but may require repeated treatments.
  • More extensive surgery could provide a permanent solution but comes with greater risks and longer recovery.

Patient Experience

• The infant could experience mild discomfort or irritation at the surgical site.
• Pain management may include over-the-counter analgesics as recommended by the physician.
• Most infants recover quickly with minimal distress and resume normal urination almost immediately.