Definition:
it consists in the incision of the ventral part of the glans, with subsequent juxtaposition of the mucous edges of the urethra, to better check possible bleeding occurrences.
Indications:
it is a procedure aimed at the solution of a stenosis of the external urethral meatus. This can be congenital (and associated with other congenital malformations, such as hypospadias) or secondary to specific or nonspecific local phlogistic phenomena, or to traumas, more often represented by iatrogenic situations, such as catheterization or the use of endoscopic urethral instrumentation.
Description of the technique:
with a scalpel blade or an electric scalpel, the ventral margin of the external urethral meatus is incised, proceeding proximally into the glandular urethra to reach the point where the lumen of this regains a regular caliber.
Preparation for intervention:
antibiotic prophylaxis.
Type of anesthesia:
a local infiltration with anesthetic may suffice, associating it, due to the need to calibrate the distal urethra, to the introduction into the urethral lumen of anesthetic gel.
Duration of the intervention:
few minutes.
Type and duration of hospitalization:
it is performed in Day-Surgery.
Results:
satisfactory from the functional point of view, not so from the aesthetic point of view. An exception is the stenosis of the secondary meatus at Balanitis Xerotica Obliterans: in this case the tendency to relapse is high, due to the characteristic of the disease of affecting both the glans, and the foreskin and the navicular ditch; in these cases the local application of steroids and antibiotics that stabilize the inflammatory component and offer more guarantees to a meatoplasty intervention seems to be indicated.
Advantages:
simple intervention.
Disadvantages:
aesthetically it is not ideal, if you do not associate a meatoplasty; also from a functional point of view it can be conditioning the mitto a bagnafiore that is realized.
Complications:
relapse, frequent in Balanitis Xerotica Obliterans.
Attention at discharge:
it may be useful in preventing relapses to keep the edges of the incision separate and lubricate the part by the tip of a tube for antibiotic ophthalmic ointments, to be used at least three times a day for 7-10 days.
Checks:
periodic evaluations of urethral lumen patency (uroflowmetry, urethral calibration of necessity).