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Meatotomy / urethral dilatation and urethrotomy
Category: Urology Procedures & Tests · All urology procedures & tests
What it is
These procedures treat narrowing (stricture) of the urine tube (urethra). Dilatation stretches the narrowing with graduated instruments; internal urethrotomy cuts the scar tissue under direct vision with a telescope-mounted knife; meatotomy widens a narrowed urine opening (meatus) at the tip of the penis.
Why it is done
They are used for strictures causing weak flow, spraying, straining or retention, caused by previous instrumentation, infection, injury or skin disease (lichen sclerosus).
How to prepare
You will have a flow test, scans of bladder emptying, and often a telescopic inspection or X-ray of the urethra (urethrogram) to map the stricture first. Infection is treated beforehand. Anaesthetic is general or spinal for urethrotomy; simple dilatation can sometimes be done under local anaesthetic.
What happens during the procedure
The surgeon passes a telescope to the stricture and either stretches it or makes a precise cut in the scar to open the channel, then sizes the passage. A catheter is usually left for a few days to keep the channel open while it heals. Procedures take about 20 to 45 minutes.
Afterwards — recovery & results
Expect blood-stained urine and stinging for a few days after catheter removal. You may be taught intermittent self-dilatation to keep the channel open. Follow-up flow tests monitor for re-narrowing.
Risks & considerations
The main issue is recurrence: strictures commonly re-form, especially longer ones, and repeated cutting has diminishing returns — in which case reconstructive surgery (urethroplasty) is discussed. Other risks include bleeding, infection and false passage creation during dilatation.
Watch: Meatotomy / urethral dilatation and urethrotomy videos
Real procedure videos from the MedicalVideos.com library. Some clinical footage is graphic — that is the nature of a medical video library.
Frequently asked questions
Why does the narrowing keep coming back?
Stricture is scar tissue, and scar contracts as it matures. Short, first-time strictures do best with endoscopic treatment; long or recurrent ones usually need open reconstruction for a lasting cure.
What is self-dilatation?
Passing a smooth catheter periodically to keep the passage stretched — a maintenance technique your team teaches if your stricture pattern suits it.
Related procedures — Urology Procedures & Tests
Browse the M section of the A–Z list or return to the Procedures & Tests hub.