# Meatal Stenosis



## Fi. (May 3, 2005)

Give me all you got on this. A friend of mines baby has it, and she wants information. The only articles she's able to find are from the 30s and 40s.

Thank you muchly


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## Revamp (May 12, 2006)

Caused by circumcision, perhaps something to do with leaving an gaping open wound in a packet full a faeces?

Medical stuff should probably be dealt with by her doctor, I believe it is not fatal. What you can do is use it to convince her should she have another boy. From my experience the pros seem to be highly succeptible to annecdotal evidence so this should work a treat.


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## pdx.mothernurture (May 27, 2004)

http://www.emedicine.com/PED/topic2356.htm

Quote:

Background: Genital disorders are commonly encountered in the office of the primary care physician. Meatal stenosis is a relatively common acquired condition occurring in 9-10% of males who are circumcised. This disorder is characterized by an upward deflected, difficult-to-aim urinary stream and, occasionally, dysuria and urgent, frequent, and prolonged urination. Surgical meatotomy is curative.

Pathophysiology: After circumcision, a child who is not toilet trained persistently exposes the meatus to urine, resulting in inflammation (ammoniacal dermatitis) and mechanical trauma as the meatus rubs against a wet diaper. This causes the loss of the delicate epithelial lining of the distal urethra. This loss may result in adherence of the epithelial lining at the ventral side, leaving a pinpoint orifice at the tip of the glans. Because this condition is exceedingly rare in children who are not circumcised, circumcision is believed to be the most important causative factor of meatal stenosis. Another hypothetical cause of this condition is ischemia due to damage to the frenular artery during circumcision, resulting in poor blood supply to the meatus and subsequent stenosis.
My circed dss aquired this condition, and had a meatotomy under general anesthesia as a toddler.

Jen


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## pdx.mothernurture (May 27, 2004)

A labeled drawing: http://www.drkoop.com/images/ency/fullsize/8861.jpg


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## Revamp (May 12, 2006)

What exactly does a meatonomy involve?


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## Fi. (May 3, 2005)

Quote:


Originally Posted by *Revamp*
Caused by circumcision, perhaps something to do with leaving an gaping open wound in a packet full a faeces?

Medical stuff should probably be dealt with by her doctor, I believe it is not fatal. What you can do is use it to convince her should she have another boy. From my experience the pros seem to be highly succeptible to annecdotal evidence so this should work a treat.

Thanks, but this is not what I'm asking. She did not do it for cosmetic reasons and will be doing it again if she has another boy. She believes and hopes she's having a girl so it will probably be a non-issue. Her doctor said he's never heard of it/seen it happen so I'm trying to get some information together for her to either take to him or for her to arm herself with so she can see another doctor.

I asked for help with her current issue and I'm hoping I don't get many more replies such as yours as they do nothing positive for her and her son.


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## Revamp (May 12, 2006)

Oh, whoops!

Well check out this site's page on the issue: http://medindia.net/patients/patient...alstenosis.asp

Sorry but the condition and issue do sorta overlap as you can see here: http://www.cirp.org/library/complications/persad/

I doubt doctors would suggest a circ since this is actually something that circumcision generally _causes_ so my guess is it would not be of much use getting it to go away.

Apologies if it offended you or anything but I was certain that was what you meant! Seems odd an intact boy would get it, the chances of that were tiny so I guess he just got really unlucky.

Oh well, hope I was of some help!


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## Sijae (May 5, 2006)

Quote:


Originally Posted by *Revamp*
Oh, whoops!

Well check out this site's page on the issue: http://medindia.net/patients/patient...alstenosis.asp

Sorry but the condition and issue do sorta overlap as you can see here: http://www.cirp.org/library/complications/persad/

I doubt doctors would suggest a circ since this is actually something that circumcision generally _causes_ so my guess is it would not be of much use getting it to go away.

Apologies if it offended you or anything but I was certain that was what you meant! Seems odd an intact boy would get it, the chances of that were tiny so I guess he just got really unlucky.

Oh well, hope I was of some help!


No, I think you had it right in the first place. The OP is talking about a friend with a circ'd baby with this condition. I think what she was saying is that her friend chose to mutilate her child for non-cosmetic reasons and plans to circ all future boys as well.

I think your original post was totally appropriate considering this forum is about the case AGAINST circumcision and the condition referenced is caused by circumcision.

Laura


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## Revamp (May 12, 2006)

Quote:


Originally Posted by *Sijae*
No, I think you had it right in the first place. The OP is talking about a friend with a circ'd baby with this condition. I think what she was saying is that her friend chose to mutilate her child for non-cosmetic reasons and plans to circ all future boys as well.

I think your original post was totally appropriate considering this forum is about the case AGAINST circumcision and the condition referenced is caused by circumcision.

Oh!

Well, whoops again. I misunderstood.

Actually in retrospect it is sort of obvious what she meant there, I feel kinda silly for not getting it.

Well, the links I posted still stand and I still think that this could be of some use convincing her should she have a second son.

Once again, I hope I was of some help.


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## pdx.mothernurture (May 27, 2004)

Quote:


Originally Posted by *Revamp*
What exactly does a meatonomy involve?

Cutting and stretching the urinary opening back open.

Jen


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## Fi. (May 3, 2005)

Quote:

I think your original post was totally appropriate considering this forum is about the case AGAINST circumcision and the condition referenced is caused by circumcision.
Right, absolutely. It's very appropriate.

However I asked for help. That wasn't helpful. That was all I was trying to say.


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## Revamp (May 12, 2006)

Quote:


Originally Posted by *pdx.mothernurture*
Cutting and stretching the urinary opening back open.

OUCH!

_More_ cutting?

Sheesh... It is like someone has a grudge against the male genitals or something: first they hack off a part without a reason and because of that more surgery involving sharp objects is performed on another highly sensitive area of the body.

Three cheers for circumcision complications...


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## Revamp (May 12, 2006)

Quote:


Originally Posted by *Fi.*
Right, absolutely. However I asked for help. That wasn't helpful. That was all I was trying to say.

Well I did give links. And it could be helpful in saving her next son from mutilation, just a suggestion.

Sorry if it annoyed you, just trying to be of some use.


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## Fi. (May 3, 2005)

Quote:

And it could be helpful in saving her next son from mutilation
She's doing it again if she has another son. Period. It's not up for discussion. It is a reason we aren't allowed to talk about here and she's already made up her mind.

And don't mind me - I'm trying to get help from her and everyone is intent on saving her next baby even though all I'm trying to get is help for this one.


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## Revamp (May 12, 2006)

Quote:


Originally Posted by *Fi.*
She's doing it again if she has another son. Period. It's not up for discussion. It is a reason we aren't allowed to talk about here and she's already made up her mind.

And don't mind me - I'm trying to get help from her and everyone is intent on saving her next baby even though all I'm trying to get is help for this one.

Wait, does "Everyone" include myself?

Because I did post you a link on the issue.

But yes, I am concerned about it and perhaps I thought that actual first hand experience with a circumcision complication would alter her mind. I am sorry to hear that it will not but since you did not mention that in your first post I was not to know. I would understand you being annoyed at me on any other board but when you come onto a forum called "The Case Against Circumcision" and talk about a boy's circumcision complication it is pretty certain that someone is going to mention persuading her not to do it again.

All the same, sorry again if I annoyed you.

And it is a pity about the secrecy thing, I have yet to see an argument that can not be countered on this issue.


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## pdx.mothernurture (May 27, 2004)

Quote:


Originally Posted by *Fi.*
She's doing it again if she has another son. Period. It's not up for discussion. It is a reason we aren't allowed to talk about here and she's already made up her mind.

And don't mind me - I'm trying to get help from her and everyone is intent on saving her next baby even though all I'm trying to get is help for this one.

Fi, it's pretty simple---he needs a meatotomy. It's more surgery. They can usually (supposedly) do it with a local. Some kids are too freaked to sit still and have shots in their penis, so he may need a general and all of it's accompanying risks. It's going to burn horribly when he pees for awhile, because the opening he pees from is going to be an open wound.

If she's insistant on circumcising, maybe she can opt for the loosest cut possible to damage the least amount of blood vessels, since decreased blood flow slows healing and contributes to ulceration and subsequent stenosis.

She might also consider, if she has another son, using a barrier cream or ointment the entire time he's in diapers to prevent urine from burning the glans and meatus, and also to change him very, very frequently.

I know "R" is a hard issue to deal with, and some parents can't be dissuaded. I'm sure it's frustrating/upsetting to you, so kudos to you for doing what you can for her and her son dispite this completely preventable complication.

Jen


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## Revamp (May 12, 2006)

Quote:


Originally Posted by *pdx.mothernurture*
It's going to burn horribly when he pees for awhile

_Again?_


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## pdx.mothernurture (May 27, 2004)

Yep, Revamp. More cutting. More pain. More burning during urination. Another wound. Again. All because he didn't have a foreskin to protect his glans and meatus, and has decreased blood flow to his penis that impedes healing. Poor kiddo. At least 1/10 circed boys aquire meatal stenosis. Many more boys will have recircumcisions because their parents feel insufficient skin was removed during the initial circumcision. Others with botched jobs require other types of surgery. So many parents believe that once the initial healing is complete, they're out of the woods. Not so.

Jen


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## stever_45723 (Feb 21, 2006)

Meatal stenosis is the great dirty secret of neonatla circumcision. It affects to one degree or another 9-13% of all neonatal circumcised boys, and it is clearly caused by the circumcision becaue the condition is virtually unknown in uncircumcised boys. But parents don't realize there's a connection between the neonatal circumcison and the meatal stenosis because they don't realize the boy has th eproblem until they try to potty train him and discover there are problems with maintaining a steady stream of urine. I am certain that all doctors know the cause of the stenosis; I do not know of a single case in which the doctor told th eparents that the cause of the stenosis was the circumcision, an dit has been so long since the circumcision that parents understandably don't make the conneciton. They just assume their son has this condition and that it was something beyond their control.


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## Islay (Apr 29, 2006)

Fi... (notwithstanding the state of English hospitals - that subject is done, dusted and put aside now, I hope) I have a less extreme suggestion that just _might_ be an option.

Sadly, I was circumcised as an adult, as you may know. I suffered penile meatal stenosis shortly after the surgery. My condition as an adult could well have been very different from that of a little boy, so that must be kept in mind.

The opening was stretched by the insertion of a bulbous plastic 'stick', with a pull-push motion in and out. It was very unpleasant, of course, and had to be done several times. Nonetheless, it involved no additional surgery and it WORKED.

Christopher


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## Fi. (May 3, 2005)

Quote:

Wait, does "Everyone" include myself?
No, I mean in general - people I've asked so far. They're all like OH see now she won't do it again if she has another baby and really, that's not what I'm looking for. Honestly that's the least of my concerns, her child who is currently having the issue is the one I'm worried about.


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## Frankly Speaking (May 24, 2002)

Christopher, the "stick" is called a urethral dialator and it is an instrument of torture as I'm sure you know.

Frank


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## Frankly Speaking (May 24, 2002)

Fi, as has been stated, the cause is the frenular artery is severed during the circumcision and this results in a diminished blood flow to the underside of the glans in the area of the frenulum and urinary meatus. It most often presents as a red, irritated or weepy area on the underside of the glans. Originally, it was suspected to be caused by inattentive mothers who did not change their son's diapers frequently or often enough and was suspected to be a case of amoniacial dermatitis. Now they know the cause and it is a very common complication of circumcision. Because the blood flow to the area is diminished, the area is starved for healing oxygen and the normal wear and tear occurs faster than the child's body can repair it. It seems that most outgrow the condition. I suspect that is because the area becomes so heavily scarred that there is eventually a barrier of scar tissue. The condition can go on for years. I know of one mother who is still battling it in her 8 year old son.

There is no cure and there is little she can do other than using barrier creams. It can become deadly by completely blocking the free flow of urine and causing bladder or kidney damage. The treatment is a meatotomy as Jen described. The urinary opening heals with scar tissue until it becomes completely blocked (or nearly so) and at that time, the urinary opening must be re-opened. This is usually done with surgical scissors. The tip of one blade is inserted into the urethra and then the two sides are brought together to cut the opening larger. In the fairly recent past, this was done with no anesthesia and is incredibly painful. Tell her to insist that she be there during the procedure and that she insist that analgesia or anesthesia be used.

Frank


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## Revamp (May 12, 2006)

Ugh...It still disgusts me. All this painful penis surgery leading back to another piece of painful penis surgery.

But it sounds like a solution. Just not a very pleasant one.


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## kathy1_10 (Jul 18, 2004)

My friends teenage son is currently getting his penis treated for it. She was talking about it at work as her son was having issues with his penis and he didn't want her to look at his penis and she kind of demanded to pull his pants down so she can take a look at it. I told her I would of just took him to a doctor to have it checked out.


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## Revamp (May 12, 2006)

How traumatic... Poor boy.

Imagine if a father did the same to a daughter!


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## Islay (Apr 29, 2006)

Quote:


Originally Posted by *Frankly Speaking*
Christopher, the "stick" is called a urethral dialator and it is an instrument of torture as I'm sure you know.

Frank


Heck, yes, Frank. When I complained emphatically that I couldn't stand it, I was given the dialator to take home and use it. I tried, but that was impossible. I had to return to the hospital, grit my teeth... and suffer.

Christopher


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