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Urology/Urethral opening

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urethral opening
urethral opening  
urethral opening
urethral opening  
QUESTION: I have a small white skin and small white bumps that have formed around my urethral opening. I was at my Gp and they said it was thrush this was 8 weeks ago and after 2 weeks of using Daktarin 2% it is still there. I have no itching or discharge but my urine stream is slow and comes out at strange angles often leading to dripping or spraying of the urine.

ANSWER: Chris:

The meatal opening appears small and compromised.  While this may have been a candida infection, it can also develop this way from various skin conditions such as BXO.  Since it is causing urinary problems, you should consult a local urologist.  Typically, we either recommend dilation using a small catheter that the patient can do themselves, or a small surgery called a meatotomy.

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QUESTION: Is a catheter a permanent thing or will it be something that will have to be used again and again over a period of time? And is a meatotomy a complete at the meatal opening or can it be repaired back to its normal state?

ANSWER: Chris:

The catheter is used as a dilator.  The use of it to keep the opening open may be short term or long term. A meatotomy is deliberately done to make the opening much wider than normal as it is expected to close somewhat during healing.  This may or may not get back to its original state.  What's important is to eliminate the abnomral constriction or narrowing.

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QUESTION: From the meatotomy how big or small would the incision made to the meatal opening? I have  seen some pictures online where the the whole meatal opening looks completely sliced through. Would these be severe cases or just  the normal procedure?

Answer
Chris:
The typical meatotomy deliberately makes the opening much, much wider and it look like it's sliced open.  This always closes even when we ask patients to spread the lips apart daily.  This is because we are concerned that it remains open more than the cosmetic appearance.  In other words, we try to make it as open as possible so it works properly.  Cosmetic appearance is secondary.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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