Meatotomy

Meatatomy is performed to repair the narrowed meatus associated with voiding difficulties.
Indication:
Meatal stenosis
1. secondary to BXO
2. secondary to hypospadias
3. secondary to circumcision
4. secondary to previous instrumentation

Pre operative care:
Voiding pattern should be observed
Meatus opening should be noted

Surgical procedure
Anaesthesia
Under local or regional or general anaesthesia
Position
Supine position
Antibiotics
Inj. Gentamycin 80mg
Types
Ventral urethral meatatomy
Dorsal meatotomy
Things

Procedure

Under local anaesthesia a ventral urethral meatatomy can be performed by inserting the needle into the skin fold from the under side.
After meatatomy, a paediatric meatal dialator is passed to prevent cut edges from sealing together.
The child’s parents are instructed to separate the edges gently with the tip of the tube 3 times a day for 7-10days

In adults
Suturing at the 3 places is necessary to approximate the urethral mucosa and control bleeding at a) the apex
b) one on either side
Dorsal meatatomy:
It is performed by Y-V plasty after the excision.

Complication
1. Bleeding
2. Re-Stenosis