Urethral Meatitis

To my knowledge, there is nothing published in medical journals or the internet about urethral meatitis. Despite this, I commonly diagnose boys in my clinic with the condition.

I refer to urethral meatitis as irritation/inflammation of the urethral opening that causes intermittent partial or complete obstruction of the urinary stream.

This condition only happens in circumcised boys.

Urethral meatitis is different from urethritis (infection of the urethra) and meatal stenosis (narrowing of the urethral meatus without inflammation).

Presentation

Boys with urethral meatitis are usually prepubertal around the age of 10. They present with difficulties with urination such as urinary spraying, difficulty starting to void, or painful urination, as well as drops of bright red blood coming from the tip of the penis after urination.

Exam

On examination, these boys have a shut close urethral meatus covered by a scab. The urethral meatus can be opened with the 2 thumb fingers of the examiner by breaking the scab exposing the pink urethral mucosa. After breaking the scab, urination is more normal and less painful.

Causes

In uncircumcised boys, the urethral meatus is always protected by the foreskin.  After circumcision, the urethral meatus is exposed to clothing, diapers, and the elements. Once boys start to become more active with sports, the irritation becomes worse and the pink urethral mucosa gets traumatized subsequently creating scabs and obstruction.

Treatment

What I have recommended to my patients is to just apply Vaseline to the tip of the penis several times a day after prying open the urethral meatus. The Vaseline does the job the foreskin was meant to do until the tissues toughen up and get used to the elements. Since I never have seen this condition in older teenagers or adults, I assume is just a phase some boys go through.

 

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