Are mechanical and chemical trauma the reason of meatal stenosis after newborn circumcision?

Prevalence and causes of meatal stenosis in circumcised boys

“…Several hypotheses have been proposed to explain its formation. Among them, the naked urethral meatus theory : in the absence of a foreskin, the mucous membrane of the meatus undergoes chronic irritation due to rubbing against the diapers or by exposure of the meatus to ammonia and other irritants in wet diapers, with subsequent development of stenosis [12,13]. Another hypothesis is that meatal stenosis develops after meatal ischemia following damage to the frenular artery at circumcision [5].…”

“…The meatal stenosis may be asymptomatic and damage the urinary system [17]. However, the diagnosis of meatal stenosis is mentioned in the presence of urine stream deviation, narrowing of the urine stream, penile pain at the initiation of urination, dysuria, hematuria, soaking of the feet in urine after each urination [12,13]. In rare cases, the symptomatology may be more severe with urinary retention, urinary tract infections, vesicoureteral re ux, thickening of the bladder wall, and bilateral hydronephrosis [18,21].…”

Systematic review of complications arising from male circumcision

“…Circumcision: Postoperative complications that required reoperation 30 17. Meatal stenosis Complication of newborn circumcision: Meatal stenosis or meatal web 68 Does circumcision increase meatal stenosis risk?-A systematic review and metaanalysis 69 Nontherapeutic circumcision of minors as an ethically problematic form of iatrogenic injury 4 Circumcision: Postoperative complications that required reoperation 30 Are mechanical and chemical trauma the reason of meatal stenosis after newborn circumcision 70 Canadian Pediatrics Society position statement on newborn circumcision: A riskbenefit analysis revisited 26 Neonatal circumcision: New recommendations & implications for practice 1 Complications of neonatal circumcision requiring surgical intervention in a developing country 40 Complications of circumcision 27 Incidence of asymptomatic meatal stenosis in children following neonatal circumcision 71 Surgically correctable morbidity from male circumcision: Indications for specialist surgical care in Lagos 43 Rates of complications after newborn circumcision in a well-baby nursery, special care nursery, and neonatal intensive care unit 29 Meatal stenosis in boys following circumcision for lichen sclerosus (balanitis xerotica obliterans) 72 18. Cicatrix Combination treatment for cicatrix after neonatal circumcision: An office-based solution to a challenging problem 73 Revisions after unsatisfactory adult circumcisions 60 Rates of complications after newborn circumcision in a well-baby nursery, special care nursery, and neonatal intensive care unit 29 19.…”

Meatal stenosis: getting the diagnosis right

“…A recent study found that MS was absent in boys with “hooded prepuce”, a condition in which the glans is completely exposed, leading the authors to conclude that chemical and mechanical traumas are not responsible for MS 5. A larger study would, however, be needed before drawing such a conclusion.…”