Background: Circumcision is the removal of the fore skin of the penis. It is one of the commonest operations performed worldwide. Meatal stenosis is an uncommon long-term complication of circumcision that can lead to problems voiding. Aim: To identify the clinical presentations and management of meatal stenosis in Port Harcourt. Materials and Methods: This was a retrospective study of patients who presented with features of meatal stenosis between January 2012 and December 2021. The patients’ history, physical examination findings, investigations and treatment received were analysed. Results: A total of 52 patients with features of meatal stenosis were recruited for the study. The number of patients less than a year old, between a year and 5 years, between 6 and 10 years and greater than 11 years were 8, 12, 28 and 4 respectively. Only 8 patients presented within 6 months of onset of symptoms. The most common symptom was poor urine stream, followed by straining. Meatotomy was the most commonly performed procedure for meatal stenosis 24 (46.15%). The patients were followed up for at least 6 months. Six patients had recurrence after treatment of meatal stenosis. Three patients each had a recurrence following dilatation and meatotomy. No patient had recurrence after meatoplasty. Conclusion: Meatal stenosis is an uncommon complication post circumcision. Patients usually present late to the hospital in our study. Meatoplasty had the best outcome. After treatment of meatal stenosis patients should be followed up for 6 months.
Morris, B.J., Moreton, S. and Krieger, J.N. (2018) Meatal Stenosis: Getting the Diagnosis Right. Research and Reports in Urology, 10, 237-239. https://doi.org/10.2147/RRU.S192310
Bossio, J.A., Pukall, C.F. and Steele, S. (2014) A Review of the Current State of the Male Circumcision Literature. The Journal of Sexual Medicine, 11, 2847-2864. https://doi.org/10.1111/jsm.12703
Joshi, K., Lessler, J., Olawore, O., Loevinsohn, G., Bushey, S., Tobian, A.A. and Grabowski, M.K. (2021) Declining HIV Incidence in Sub-Saharan Africa: A Systematic Review and Meta-Analysis of Empiric Data. Journal of the International Aids Society, 24, e25818. https://doi.org/10.1002/jia2.25818
Kennedy, C.E., Yeh, P.T., Atkins, K., Fonner, V.A., Sweat, M.D., O’Reilly, K.R., Rutherford, G.W., Baggaley, R. and Samuelson, J. (2020) Economic Compensation Interventions to Increase Uptake of Voluntary Medical Male Circumcision for HIV Prevention: A Systematic Review and Meta-Analysis. PLOS ONE, 15, e0227623. https://doi.org/10.1371/journal.pone.0227623
Hutson, J.M. (2004) Circumcision: A Surgeon’s Perspective. Journal of Medical Ethics, 30, 238-240. https://doi.org/10.1136/jme.2002.001313
Many, B.T., Rizeq, Y.K., Vacek, J., Cheon, E.C., Johnson, E., Hu, Y.Y., Raval, M.V., Abdullah, F. and Goldstein, S.D. (2020) A Contemporary Snapshot of Circumcision in US Children’s Hospitals. Journal of Pediatric Surgery, 55, 1134-1138. https://doi.org/10.1016/j.jpedsurg.2020.02.031
Lawal, T.A. and Olapade-Olaopa, E.O. (2017) Circumcision and Its Effects in Africa. Translational Andrology and Urology, 6, 149. https://doi.org/10.21037/tau.2016.12.02
Upadhyay, V., Hammodat, H.M. and Pease, P.W. (1998) Post Circumcision Meatal Stenosis: 12 Years’ Experience. The New Zealand Medical Journal, 111, 57-58.
Frisch, M. and Simonsen, J. (2018) Cultural Background, Non-Therapeutic Circumcision and the Risk of Meatal Stenosis and Other Urethral Stricture Disease: Two Nationwide Register-Based Cohort Studies in Denmark 1977-2013. The Surgeon, 16, 107-118. https://doi.org/10.1016/j.surge.2016.11.002
Joudi, M., Fathi, M. and Hiradfar, M. (2011) Incidence of Asymptomatic Meatal Stenosis in Children Following Neonatal Circumcision. Journal of Pediatric Urology, 7, 526-528. https://doi.org/10.1016/j.jpurol.2010.08.005
Godley, S.P., Sturm, R.M., Durbin-Johnson, B. and Kurzrock, E.A. (2015) Meatal Stenosis: A Retrospective Analysis of over 4000 Patients. Journal of Pediatric Urology, 11, 38.e1-6. https://doi.org/10.1016/j.jpurol.2014.09.006
Olasehinde, N. (2018) Healthcare Seeking Behavior in Nigeria. Journal of Population and Social Studies, 26, 207-218. https://doi.org/10.25133/JPSSv26n3.015
Latunji, O.O. and Akinyemi, O.O. (2018) Factors Influencing Health-Seeking Behaviour among Civil Servants in Ibadan, Nigeria. Annals of Ibadan Postgraduate Medicine, 16, 52-60.
Tanimola, M.A. and Owoyemi, J.O. (2009) Healthcare-Seeking Behaviour in Anyigba, North Central, Nigeria. Research Journal of Medical Sciences, 3, 47-51.
Brieger, W.R., Osamor, P.E., Salami, K.K., Oladepo, O. and Otusanya, S.A. (2004) Interactions between Patent Medicine Vendors and Customers in Urban and Rural Nigeria. Health Policy and Planning, 19, 177-182. https://doi.org/10.1093/heapol/czh021
Chapple, C.R., MacDiarmid, S.A. and Patel, A. (2009) Urodynamics Made Easy. 3rd Edition, Elsevier, Amsterdam, 28-38. https://doi.org/10.1002/nau.20731
Gerber, G.S. and Brendler, C.B. (2012) Evaluation of the Urologic Patient: History, Physical Examination, and Urinalysis. In: Wein, A.J., Kavoussi, L.R., Partin, A.W., Novick, A. and Peters, A.C., Eds., Campbell Walsh Urology, 10th Edition, Elsevier Saunders, Philadelphia, 75-78.
Wang, M.H. (2010) Surgical Management of Meatal Stenosis with Meatoplasty. Journal of Visualized Experiments, 45, 49-54. https://doi.org/10.3791/2213
Tanagho, E.A. (2013) Urinary Obstruction and Stasis. In: McAninch, J.W. and Lue, Y.F. Eds., Smith and Tanagho’s General Urology, 18th Edition, McGraw Hill, New York, 166-176.
Badoe, E.A., Archampong, E.Q. and Rocha-Afodu, J.T. (2009) Principles and Practice of Surgery Including Pathology in the Tropics. 4th Edition, Assemblies of God Literature Centre Ltd., Accra, 967-982.
Abhulimen, V. and Eke, N. (2018) Hydronephrosis: A Systematic Review. African Journal of Paediatric Nephrology, 5, 61-70.
Raphael, J.E. and Abhulimen, V. (2022) Sensitivity and Resistance Patterns of Gram Negative Uropathogens Isolated from the Urine of Patients with Upper/Lower Urinary Obstruction in Nigeria. Journal of Advances in Medicine and Medical Research, 34, 11-19. https://www.sdiarticle5.com/reviewhistory/86471 https://doi.org/10.9734/jammr/2022/v34i931343
Harwood, R. and Kenny, S.E. (2020) Circumcision, Meatotomy, Meatoplasty, and Preputioplasty. In: Davenport, M. and Geiger, J., Eds., Operative Pediatric Surgery, CRC Press, Boca Raton, 717-721. https://doi.org/10.1201/9781351250801-77
Fronczak, C.M. and Villanueva, C.A. (2017) Clinic Meatotomy under Topical Anesthesia. Journal of Pediatric Urology, 13, 499.e1-499.e3. https://doi.org/10.1016/j.jpurol.2017.02.014
Morris, B.J. and Krieger, J.N. (2017) Does Circumcision Increase Meatal Stenosis Risk? A Systematic Review and Meta-Analysis. Urology, 110, 16-26. https://doi.org/10.1016/j.urology.2017.07.027
Bazmamoun, H., Ghorbanpour, M. and Mousavi-Bahar, S.H. (2008) Lubrication of Circumcision Site for Prevention of Meatal Stenosis in Children Younger than 2 Years Old. Urology Journal, 5, 233-236.
Mondal, S.K., Ali, M.A., Alam, M.K., Hasina, K., Talukder, A.R., Yusuf, M.A. and Khan, J.G. (2013) Use of Lubricant at Meatus and Circumcision Site in Younger Children Prevent Post Circumcision Meatal Stenosis: A Randomized Control Trial. Journal of Shaheed Suhrawardy Medical College, 5, 35-38. https://doi.org/10.3329/jssmc.v5i1.16204
McHoney, M., Thakkar, H., Lakhoo, K. and Ringo, Y. (2020) Phimosis, Meatal Stenosis and Paraphimosis. In: Ameh, E.A., et al., Eds., Pediatric Surgery, Springer, Cham, 1011-1017. https://doi.org/10.1007/978-3-030-41724-6_96
Salimi, A., Besharati, M., Rashidi Nia, S., Shahmoradi, S. and Eftekhari, S.S. (2017) Application of the Topical Hydrocortisone Ointment Decreases Post-Circumcision Meatal Stenosis in Neonates: A Cross-Sectional Study. International Journal of Pediatrics, 5, 5061-5067.
Razzaghi, M., Rahavian, A., Fallah Karkan, M., Allameh, F., Ghiasy, S. and Javanmard, B. (2020) Use of Human Amniotic Membrane Repair of Anterior Urethral Defect: First Clinical Report. International Journal of Urology, 27, 605-609. https://doi.org/10.1111/iju.14257
Acimi, S., Abderrahmane, N., Debbous, L., Bouziani, N., Mansouri, J.M., Acimi, M.A., Boukhari, Y., Hadjeb, N. and Yazi, A.E. (2022) Prevalence and Causes of Meatal Stenosis in Circumcised Boys. Journal of Pediatric Urology, 18, 89.e1-89.e6. https://doi.org/10.1016/j.jpurol.2021.10.008