Meatotomy

A meatotomy is a short procedure that widens a narrowed opening at the tip of the penis (the meatus), so urine comes out in a normal, straight stream. It is most often done for boys who were circumcised as babies, and sometimes for men.

Also called meatoplasty, urethral meatotomy, meatal stenosis surgery, narrow opening at the tip of the penis, pinhole urethral opening, widen the pee hole, small pee hole after circumcision, urine stream sprays

Where: Clinic procedure room or outpatient surgery center
Anesthesia: Numbing cream and a numbing injection; brief general anesthesia for many young children
Time in the room: About 10 to 20 minutes
Hospital stay: Same day
Back to normal: 1 to 3 days
Back to work: Back to school or work in 1 to 2 days

See the steps

Head (glans)OpeningUrethraShaft

Where it happens. The highlighted part is what this procedure treats.

Overview

The meatus is the opening at the tip of the penis where urine comes out. Meatal stenosis means this opening has become too narrow. Instead of a normal stream, urine comes out in a thin, fast jet that often shoots upward or sprays. Boys may have to push the penis down to aim, take a long time to empty, or feel burning at the tip.

In boys, meatal stenosis is most common after circumcision in infancy, and it usually shows up between about 3 and 10 years of age, once someone notices the stream. The exact cause is not certain; irritation of the uncovered tip in diapers, or a change in its blood supply, may play a part. In men, it can follow lichen sclerosus (a skin condition that scars the tip of the penis), catheters, scopes or earlier surgery.

A meatotomy opens the thin web of tissue on the underside of the opening. The surgeon makes a small cut and often sews the edges with tiny dissolving stitches so they stay apart (sometimes called a meatoplasty). It takes only a few minutes. The part of recovery that needs the most care is keeping the new opening from sealing shut as it heals, which is done at home with ointment for a few weeks.

This page covers both boys and men. Where things differ for children, it says so.

The parts of your body involved

The urethra is the tube that carries urine from the bladder to the outside. It ends at the meatus, a slit-shaped opening at the tip of the glans (the head of the penis). Normally the opening is an up-and-down slit several millimeters long. In meatal stenosis, a thin web of tissue on the underside closes the lower part of the slit, leaving a small round pinhole.

Glans
The head of the penis.
Meatus
The opening at the tip of the glans where urine comes out. Normally a slit, it becomes a pinhole in meatal stenosis.
Urethra
The tube that carries urine from the bladder to the meatus.
The web on the underside
The thin band of tissue that narrows the opening. Because it sits on the underside, the stream is pushed upward.

Why it’s done

A meatotomy is usually suggested when the narrowing causes symptoms, or when an exam shows the opening is clearly too small.

A stream that sprays or shoots upward
Boys may wet the toilet seat, wall or their clothes, or have to push the penis down to aim.
Straining or slow emptying
A long time to empty the bladder, or needing to push to start or keep the stream going.
Burning or a spot of blood
Discomfort at the tip, or a small spot of blood in the underwear, can come from the narrowed, irritated opening.
Not emptying fully or infections
Less often, a tight opening keeps the bladder from emptying fully or contributes to urinary infections.
Making room for other procedures
In men, a tight opening can block a catheter or a scope needed for other care.

Other options

Watching
If the stream is only slightly off and there are no other symptoms, waiting and checking again later is reasonable.
Steroid ointment for lichen sclerosus
When lichen sclerosus is the cause, a strong steroid ointment can calm the skin and may soften the narrowing. It is often used along with a meatotomy.
Dilation
Gently stretching the opening with smooth dilators. Used alone, the narrowing tends to come back.
Urethroplasty
For men whose narrowing runs deeper into the urethra, a reconstruction, sometimes with a graft from the inside of the cheek, may be needed.

Getting ready

Tick items off as you go. Your checklist is saved on this device only.

Weeks before

Exam and stream check

The urologist looks at the opening and may watch the stream or do a urine flow test. An ultrasound may check that the bladder empties well.

Where it will be done

Adults and older, calm children can often have it in the clinic with numbing cream and a small injection. Young children usually have it in an operating room with a brief general anesthesia so they stay comfortable and still.

Talking with your child

Use simple, honest words, for example that the doctor will make the place where pee comes out a little bigger so it comes out straight. Children cope better when they are not surprised.

The day before

Fasting, if there is anesthesia

Follow the eating and drinking rules exactly. Solid food, milk and clear liquids each have their own cut-off times.

Supplies

Petroleum jelly or the antibiotic ointment your team recommends, acetaminophen or ibuprofen, and loose, soft underwear.

Plan the next day or two

Children usually stay home for a day. Adults who have sedation need a ride home and may want a day off work.

The day of

Numbing cream, for a clinic procedure

You may be asked to put numbing cream on the tip of the penis and cover it with plastic wrap about an hour before the visit.

Comfort

Bring a favorite toy, tablet or blanket for a child, and wear loose clothes.

Pain medicine

Ask whether to give a dose of acetaminophen or ibuprofen beforehand, and check the right dose for your child's weight.

The procedure, step by step

Press play or pick a step. Each drawing shows what your surgeon is doing at that moment. Your team may do some steps differently.

YouAnesthesia team

1 / 6

1. Getting comfortable

Young children in the operating room usually fall asleep breathing anesthesia gas through a mask, often with a parent nearby. In the clinic, adults and older boys lie on the exam table awake.

Young children in the operating room usually fall asleep breathing anesthesia gas through a mask, often with a parent nearby. In the clinic, adults and older boys lie on the exam table awake.
A numbing injection at the base of the penis (a penile block), or a small injection at the tip after numbing cream, makes the area numb for several hours. Children who are asleep get this too, so they wake up comfortable.
The surgeon looks at the opening and may gently pass a small probe to measure it and check that the urethra farther in is normal.
A small clamp may be placed on the thin web on the underside of the opening for about a minute to reduce bleeding. The web is then cut with fine scissors, a few millimeters, to make a normal slit.
Many surgeons place a few tiny dissolving stitches to sew the inner lining to the skin on each side. This keeps the edges apart while they heal. The stitches fall out on their own over 1 to 3 weeks.
The surgeon checks that the new opening is wide and points straight ahead, then applies ointment. There is usually no catheter and no bandage to change.

After the procedure

Right afterward

Going home
Most people go home within an hour or two. Children who had anesthesia may be sleepy or fussy for the rest of the day.
The first pee
The first few pees sting. Peeing while sitting in a few inches of warm bath water can help young children, if your team allows it.
A little blood
A few drops of blood at the tip or on the underwear are normal for a day or two.
Pain
Acetaminophen or ibuprofen is usually enough.

At home

Keeping the opening from sealing
Apply ointment to the tip several times a day, especially after peeing, for as long as your team advises, often about 2 to 6 weeks. Many surgeons also ask you to gently spread the lips of the opening apart, or slide the tip of the ointment tube just into it, so the raw edges do not stick back together. Your team will show you how.
Bathing
Baths or showers are usually fine from the next day.
Burning
Stinging with peeing usually fades over 2 to 3 days. Drinking plenty helps by keeping the urine dilute.
How it looks
The tip may look swollen and red, with a soft yellow film, for a week or so. That film is normal healing tissue and is not a sign of infection.
The stream
The stream may spray for a few days while the tip is swollen. It usually becomes straight within 1 to 2 weeks.
Diapers
For a child still in diapers, put ointment on the tip and on the diaper at every change so the tip does not stick.
Activity
Normal play and school after a day or two. Avoid bicycles and straddle toys for a few days if they are uncomfortable.
Adults
Return to work in 1 to 2 days. Avoid sex for about 2 weeks, until the tip has healed.

Recovery timeline

Day 0
Procedure
A short procedure, and home the same day.
Days 1 to 3
Stinging fades
Peeing becomes comfortable again, and school or work can resume.
Week 1
Healing
Swelling settles, and the stitches begin to fall out.
Weeks 2 to 6
Ointment routine
Keep up the ointment for as long as your team advises. The stream should now be straight.
1 to 3 months
Check-up
A visit to confirm the opening has stayed open and the stream is normal.
Later
Usually nothing more
Most people need no further treatment. If the stream starts to spray or thin again, see your urologist.

What it feels like

For most families, the procedure itself is quick, and the worry beforehand is bigger than the recovery. The part that takes the most effort is the ointment routine at home.

Before the procedure
Parents often wonder whether circumcision, or something they did, caused this. Adults may feel embarrassed to bring it up.
What helpsMeatal stenosis is common and is not caused by how a child was cared for. It is also one of the simplest problems a urologist fixes.
Waking up, for children
Children waking from anesthesia can be confused, cry or thrash for a short time, even without pain.
What helpsHold and comfort your child. This usually passes within half an hour.
The first pee
It stings, and some children are scared and try to hold it.
What helpsEncourage drinks, let them pee in warm bath water if allowed, and use distraction. The numbing injection helps for the first few hours.
The ointment routine
Children may resist, and adults can find it awkward.
What helpsMake it a quick, matter-of-fact part of every bathroom trip. A small reward chart works well for young children.
The new stream
Many boys are proud to aim straight, and parents notice far less mess in the bathroom.
What helpsIf the stream still sprays after 2 weeks, mention it at the follow-up visit.

How well it works

Success means a straight, comfortable stream and a normal-looking opening.

High success
Most boys have a normal stream after one meatotomy. The narrowing returns in a small number, most often when the edges heal together in the first weeks.
In adults
Results are good when the narrowing is limited to the tip. When lichen sclerosus is the cause, the narrowing is more likely to return, and ongoing skin treatment helps.
Follow-up
A check-up after a few weeks to months confirms the opening has stayed wide.

Risks

Every operation has risks. These are the ones people ask about most, with honest odds where good numbers exist. Your surgeon’s own results matter more than averages.

Common

Stinging with urination

Expected for 2 to 3 days.

A little bleeding

A few drops of blood at the tip for a day or two.

Swelling and a spraying stream

Common in the first days while the tip is swollen.

Less common

Narrowing comes back

Most often when the edges heal together in the first weeks. A repeat procedure is usually simple.

Infection

Uncommon. Spreading redness, pus or fever needs a call to your team.

Bleeding that needs attention

Occasionally bleeding needs firm pressure or an extra stitch.

Rare

Opening heals too wide or too low

Rarely the opening heals larger or lower than intended, which can change the direction of the stream a little.

Problems with anesthesia

Serious problems with a brief anesthetic in a healthy child are very rare.

Call your care team or go to the emergency room if

No urine for 8 hours or more, or a full, painful bladder with little or no stream
Bleeding that does not stop after 10 minutes of firm, steady pressure with gauze
Fever of 101°F (38.3°C) or higher
Redness spreading up the penis, increasing swelling, or pus
Pain that is not helped by acetaminophen or ibuprofen
In a child, vomiting that does not stop or refusing to drink after anesthesia

Questions to ask your surgeon

Is the opening narrow enough that a meatotomy will help?
Can this be done in the clinic, or should it be in the operating room?
Will you use stitches?
How should we apply the ointment, how often, and for how long?
Which pain medicine and what dose do you recommend?
When can my son go back to school, swimming and sports?
What are the chances the narrowing comes back?
Could lichen sclerosus be playing a part, and does it need treatment?
When is the follow-up visit?

Words you may hear

Meatus: The opening at the tip of the penis where urine comes out.
Meatal stenosis: Narrowing of the meatus.
Meatotomy: A small cut to widen the meatus.
Meatoplasty: A meatotomy with stitches to shape the new opening and keep it open.
Glans: The head of the penis.
Urethra: The tube that carries urine from the bladder out of the body.
Lichen sclerosus: A long-term skin condition that can scar the tip of the penis.
Penile block: A numbing injection at the base of the penis.
Dissolving stitches: Stitches that fall out or dissolve on their own and do not need removal.
Numbing cream: A cream that numbs the skin before an injection or small procedure.

Common questions

Did circumcision cause this?

Meatal stenosis is more common in boys who were circumcised as babies, but most circumcised boys never develop it. It is not caused by how you cared for your son, and it is easy to treat.

Does my son need to be put to sleep?

Not always. Some older, calm boys do well in the clinic with numbing cream and a small injection. Many younger children are more comfortable having a brief anesthesia in the operating room. Your urologist will help you decide.

Will the penis look different?

The opening will look like a normal slit. Most people would not notice any difference.

Will this affect fertility or sexual function?

No. Only the opening at the tip is changed.

How soon will the stream be normal?

Usually within 1 to 2 weeks, once the swelling settles.

Can it come back?

It can, but uncommonly. Keeping up the ointment routine in the first weeks is the best way to prevent it.

Sources this page draws on

MedlinePlus, U.S. National Library of Medicine, Meatal stenosis
European Association of Urology (EAU) and European Society for Paediatric Urology (ESPU), Guidelines on Paediatric Urology
American Academy of Pediatrics, Circumcision Policy Statement (2012)
Elsevier, Campbell-Walsh-Wein Urology (textbook), pediatric and urethral surgery chapters

Written November 2026. This page explains what usually happens. It is not medical advice and does not replace a conversation with your own surgeon, whose plan for you comes first.