Incidence of meatal stenosis following circumcision done in nappy aged children

Introduction: Meatal stenosis is a recognized complication of circumcision done during nappy aged boys as a late presentation. The objective of this study was to describe the incidence of documented meatal stenosis in boys circumcised in infantile period.
Method: Meatal stenosis was defined as change in appearance of the delicate lips of the urinary meatus, with loss of ellipticated shape to a circular shape because of scar and visually apparent narrowing. The study included 356 consecutive samples of boys aged 6 months to 6 years (mean 2.5 y.o), circumcised in first 2 months of life, who visited in my private office referred for reasons urinary or non urinary complaints.
Results: The diagnosis was made in 32 of 365. Four of 32 stenotic cases were asymptomatic, common symptoms in other 28 boys were decreased urine caliber (11), crying before or during voiding (8), dysuria (5), penile deviation (3), bloody spotting (3). None cases had urinary tract infection,  urinary tract sonography was within normal limit in all cases.
Conclusion: Meatal stenosis is a complication of circumcision done during nappy aged boys as a late presentation. A careful meatal examination is indicated in any boys with history of circumcision during nappy age. We recommend to use lubricant or anti inflammatory ointments for prevention of meatal fibrosis and stenosis.