The Section on Urology of the American Academy of Pediatrics has charged this committee with the task of evaluating the status of the question of meatal stenosis in boys (excluding those with hypospadias). The objective information on the subject is limited; however, our conclusions, based on review of available literature and the committee's deliberations, are as follows.
Meatitis, an inflammation generally secondary to ammoniacal diaper irritation, has been cited as the underlying cause of secondary meatal stenosis.1 The lack of protection by the foreskin in the circumcised male is thought to correlate with an increased incidence of meatitis. Meatal narrowing has been noted to occur more commonly in the circumcised male.1,2 The formation of a ventral lip of tissue is characteristic of secondary meatal narrowing and may cause deflection of the urinary stream upward. Campbell, however, suggested that congenital meatal stenosis is the underlying cause of meatitis,3 whereas Allen and Summers believe meatitis can be either the cause or the effect of meatal stenosis.2 Other factors which have been stated to influence the development of secondary meatal stenosis include abrasions and diet.2
Incidence and Measurement
Calibration of the urethral meatus by Allen et al.4 demonstrated that 9% of newborn boys have a meatus tight to 4F which the authors consider to be congenital meatal stenosis. In a later article the same authors reported the results of visual inspection in a group of 1,800 boys, ages 6 to 10 years. Thirty-two percent were considered to have a "pinpoint meatus."
- Copyright © 1978 by the American Academy of Pediatrics