Meatal Stenosis: Lichen Sclerosis
Lichen sclerosus (LS) affecting the penile meatus causes white, atrophic plaques and scarring that can narrow the meatus. This leads to lower urinary tract symptoms and in severe case urinary retention. This condition can also lead to phimosis, where the foreskin becomes tight, and can cause difficulty with urination and sexual function. Treatment typically starts with topical corticosteroids, and surgery such as circumcision or meatotomy may be necessary for more severe or stubborn cases.
Symptoms and effects
- Narrowed meatus: The meatus can narrow to the point of causing urinary retention, potentially damaging the bladder and kidneys over time.
- Phimosis: In uncircumcised men, LS can cause the foreskin to become so tight that it cannot be retracted.
- Urinary problems: A less powerful stream, spraying of urine, and urinary frequency are common symptoms.
- Pain and scarring: It can cause pain during urination and intercourse, and lead to scarring of the glans, foreskin, and frenulum.
- Other symptoms: Blisters, sores, and itching can also occur, though these are less common.
Treatment
- Medical therapy: The first-line treatment is often an ultrapotent topical corticosteroid, such as clobetasol propionate, applied to the affected areas.
- Circumcision: This is often curative for LS confined to the foreskin and glans.
- Meatotomy: In some cases, a surgical procedure to widen the meatus may be required.
- Dilation: Daily self dilations
- Other treatments: Depending on the individual case, other treatments may be considered, including phototherapy or laser treatments.
- Surgical reconstruction: Some patients may require more extensive reconstructive procedures.
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