Meatotomy

  1. Marilakshmi Nurse Educator, Kauvery Hospital, Tirunelveli

Background

A meatotomy is a form of penile modification in which the underside of the glans is split, extending the urinary meatus. The procedure may be performed by a doctor to alleviate meatal stenosis or urethral stricture. A meatotomy is sometimes also self-performed voluntarily for aesthetic reasons, or to open the urethra for sexual gratification as part of the practice of sounding.

A variety of techniques may be used to make the cut, but a doctor will generally crush the ventral meatus, urethra, and upper frenulum for 60 s with a straight Kelly hemostat and then divide the crush line with fine-tipped scissors.

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Case Presentation

The patient was a 74 yrs aged male admitted with complaints of reduced urine output with dripping of urine associated with burning micturition and pitting and pedal edema for 1 month. He was a known case of Type 2 diabetes mellitus and thyroid disorder for past 5 years. In view of the above findings and investigations the patient had undergone meatotomy surgery.

Examination

  1. CVS: S1, S2, RS: Bilateral air entry present
  2. SAO2: 97%, BP: 130\80 mmhg, HR: 100 beats\min, RR: 22 breath\min

Patient is conscious, oriented to time, place and person. Pitting and pedal edema is present.

Lab investigations

  1. Hb: 13.2 gm|dl, PCV: 42.1, Platelet: 214000
  2. Urea: 25.1, Creatnine: 0.80
  3. BT: 3 min 45 s, CT: 5 min, INR: 1.16
  4. Na: 136.7, K+: 3.71
  5. HIV, HCV, HbsAg: Negative.

ECHO report: Within normal limits

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Ultrasound report: Within normal limits

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Treatment

  1. Tab.lonazep-0.5mg
  2. Inj.lupitum-1.125gm
  3. Inj.levoflox-500mg
  4. Inj.dyter-100mg
  5. Tab.cidmus-sos
  6. Inj.Deriphylline-

Diet advice

Normal diet.

Nursing instructions

  1. Give a nonsteroidal anti-inflammatory drug (NSAID) like ibuprofen (Advil, Motrin) for pain.
  2. Apply an antibiotic ointment, such as Neosporin or Bacitracin, to the tip of the penis twice a day for at least two weeks.
  3. Make a warm bath for the patient to sit in to relieve pain 24 hours after the procedure is done.
  4. If instructed, insert a lubricated dilator into the meatus two times a day for six weeks to keep it from narrowing.
  5. Nurses used the AIDET techniques acknowledge, duration, explanation and thank you while communicating the patient and attenders to give their confidence and improve the satisfaction level.
  6. Patient stabilized discharge followed as per doctors’ advice.

Outcome

On discharge, patient was hemodynamically stable.

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Ms. K. Marilakshmi

Nurse Educator

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