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Meatotomy
What is
Meatotomy?
A
meatotomy is a form of penile modification in
which the underside of the glans is split. The
procedure may be performed by a doctor to
alleviate meatal stenosis or urethral stricture,
or by a body modification practitioner for the
purpose of sexual pleasure or aesthetics.
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Effects
of Meatotomy
Aside
from the exposure of previously internal
tissues, the newly enlarged urethral opening may
hinder the ability to control the direction and
shape of one's urine stream. This may result in
messy urination and require that the
meatotomized individual sit while urinating,
however this is not universally true. The larger
urethral opening may also reduce the velocity of
ejaculate, thereby reducing distance of
ejaculation.
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Candidates for Meatotomy
The
procedure may be performed by a doctor to
alleviate meatal stenosis, urethral stricture,
or by a body modification practitioner for the
purpose of sexual pleasure or aesthetics. A
meatotomy can also result from a Prince Albert
piercing being torn out. Some penises have a
naturally split underside of the glans as a
result of hypospadias. For some men, a greater
sensation may be achieved with exposure of and
access to the urethra due to the abundance of
nerves.
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Your Consultation
Meatal
stenosis is not a cause of urinary tract
infections, hydronephrosis, or any form of
obstruction of the lower urinary tract. For this
reason, no further urological investigation is
warranted. If the diagnosis is in question,
observing the child void, with particular
attention to the force of the stream
(increased), caliber of the stream (decreased),
and duration of the voiding episode (usually
prolonged), is helpful. If an elimination
disorder is suspected, noninvasive urodynamics
such as uroflow with electromyography (pad
electrodes) and measurement of bladder capacity
and postvoid residuals could be indicated. If
associated infection is a possibility,
urinalysis with culture should be obtained.
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The
Meatotomy Procedure
A
variety of techniques may be used to make the
cut, but a doctor will generally crush the
vernal meatus, urethra, and upper frenulum for
60 seconds with a straight mosquito hemostat and
then divide crush line with fine-tipped
scissors. Other techniques include cauterisation,
cutting with a scalpel (sometimes aided by
clamps) or by using existing fistulas from
piercings to tie-off the area to be cut.
Depending on the anatomy of the individual and
the extent of the split, meatotomy performed
with a scalpel may involve heavy bleeding, while
crush and cauterisation methods are relatively
bloodless. Regardless of the procedure used,
meatotomies, like other genital modificiations
and genital piercings, heal quickly. Unlike
other genital modifications, the glans tissue
does not have a tendency to re-adhere to itself
or heal closed.
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Recovery
After
meatotomy, instruct caregivers to dress the
child in loose underwear for 24 hours. Restrict
activities, such as contact sports, bicycle
rides, and playground activities, for 3-4 days.
Following meatotomy, caregivers should separate
the edges of the meatus and apply antibiotic
ointment or petroleum jelly 2 times a day for 2
weeks and then 1 time a day for 2 more weeks.
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Risks
Complications include bleeding during or after
meatotomy, infection, and recurrence. All of
these complications are quite rare and respond
readily to appropriate management.
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Frequently Asked Questions
Q:
What is a meatotomy?
A:
Meatotomy is kind
of like the beginner version of
subincision (although that is an unfair
simplification). When the subincision is only
underneath the glans it is known as a meatotomy
(or, if naturally occurring, a
hypospadia). A meatotomy sometimes occurs
when a PA is torn out accidentally, but is
usually done voluntarily as a
clamp and cut procedure in order to open the
urethra, often for
sounding play.
Q:
What is a meatal stenosis?
A:
A meatotomy is a simple surgical procedure for
relieving a urethral obstruction to urine or
semen flow caused by scar tissue at the tip of
the penile urethra. This narrowing is called
meatal stenosis. Symptoms associated with meatal
stenosis could include a curved thin stream,
penile pain with urination or can be asymptotic.
Scar tissue inside the urethra is called a
urethral stricture and can have the same
symptoms.
Q:
Will the procedure hurt?
A:
Repair of a meatotomy can be painful and
difficult, and is similar to hypospadias repair.
Q: How
long is the recovery period?
A:
Meatotomies usually heal in not much more than a
week and tend to be far less difficult to heal
than a piercing.
Q:
What should I expect after a meatotomy?
A:
Meatotomies usually
damage the ability to urinate normally because
they disrupt the urine spray (that is, you'll
pee on your pants, your foot, or the guy next to
you), although this is definitely not
universally true.
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The following list of Urology procedures are
performed at Beverly Hills Medical Group -
please click the links to find out more:
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