Objective: The study aimed to document the types of meatal occlusive disease (MOD) in adult males in terms of its clinical presentation, management and prognosis. Material and Methods: Eighty-six adult males with MOD were assessed during the study period. The patients were divided into Group 1, having meatal opening that was occluded by flimsy adhesions (meatal synechia/adhesive type MOD), and Group 2 that included patients who had circumferential constriction of the meatus (meatal stenosis/constrictive type MOD). All patients underwent meatal dilatation up to 18 Fr followed by self-dilatation for 3 months with topical clobetasol for 4 weeks. Degree of discomfort during self-dilation, improvement in flow rate, International Prostate Symptom Score (IPSS score) and recurrences were recorded at pre-determined intervals. Results: Twenty-eight patients had meatal synechia (Group 1) and 48 had meatal stenosis (Group 2). Discomfort during self-dilatation in Group 1 patients was significantly less; there was improvement in IPSS and peak flow rate (mean follow-up 26.8 months) as compared to Group 2. With dilation alone, no recurrence was noted in Group 1; however, Group 2 showed 62.8% recurrence indicating poor outcome in this subset of patients. Conclusion: MOD in adult males consists of 2 separate clinical entities with different therapeutic outcomes.

Keywords:
Meatal stenosis, Meatal synechia, Meatal occlusive disease
1.
Morgan WKC: Circumcision. Can Med Assoc J 1982;126:594, 603-604.
2.
Robson WL, Leung AK: The circumcision question. Postgrad Med 1992;91:237-242, 244.
3.
Goel A, Goel A, Dalela D, Sankhwar SN: Meatoplasty using double buccal mucosal graft technique. Int Urol Nephrol 2009;41:885-887.
4.
Xue JD, Xie H, Fu Q, Feng C, Guo H, Xu YM: Single-staged improved tubularized preputial/penile skin flap urethroplasty for obliterated anterior urethral stricture: long-term results. Urol Int 2016;96:231-237.
5.
Singh O, Gupta SS, Arvind NK: Anterior urethral strictures: a brief review of the current surgical treatment. Urol Int 2011;86:1-10.
6.
Persad R, Sharma S, McTavish J, Imber C, Mouriquand PD: Clinical presentation and pathophysiology of meatal stenosis following circumcision. Br J Urol 1995;75:91-93.
7.
Buckley JC, Heyns C, Gilling P, Carney J: SIU/ICUD consultation on urethral strictures: dilation, internal urethrotomy, and stenting of male anterior urethral strictures. Urology 2014;83(3 suppl):S18-S22.
8.
Stewart L, McCammon K, Metro M, Virasoro R: SIU/ICUD consultation on urethral strictures: anterior urethra-lichen sclerosus. Urology 2014;83(3 suppl):S27-S30.
© 2016 S. Karger AG, Basel
2016
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.