Why Has the Opening of My Penis Become Smaller? Understanding Meatal Stenosis

The opening at the tip of the penis is called the urethral meatus. If this opening becomes scarred and narrower than normal, it is called meatal stenosis.

In adults, meatal stenosis can cause a thin, spraying or difficult urinary stream. It can also sometimes be the first sign of a wider penile skin or urethral condition.[1–3]

What symptoms can meatal stenosis cause?

Possible symptoms include:

• a urinary stream that is thinner, weaker or sprays

• taking longer to empty the bladder

• straining to urinate

• burning or discomfort when passing urine

• dribbling after urination

• feeling that the bladder has not emptied completely

• recurrent urinary infections in some patients.[1,2]

Some men first notice that the opening itself looks smaller. Appearance alone does not confirm meatal stenosis, because the normal size and shape of the opening varies between individuals.

Why can the opening become smaller?

Meatal stenosis usually develops because of scarring. Causes in adults can include:

• previous catheterisation or urethral procedures

• previous penile or urethral surgery

• previous hypospadias surgery

• trauma or inflammation

• lichen sclerosus, a chronic inflammatory condition affecting genital skin.[1,3–6]

Lichen sclerosus deserves particular attention because it can affect the foreskin, glans and urinary opening and may extend further into the urethra.[4–6]

Men who also notice pale or fragile penile skin, foreskin tightening, cracking or progressive urinary spraying may benefit from assessment for this condition.

Related: Lichen Sclerosus in Men

Is meatal stenosis the same as a urethral stricture?

Not exactly.

Meatal stenosis describes narrowing at the external urinary opening. A urethral stricture is scarring affecting the urethra further inside the penis.

The two can occur together. This is why treatment should consider where the narrowing starts, how far it extends and what caused it.[1–3]

Related: Urethral Stricture & Urethroplasty

How is meatal stenosis assessed?

Assessment usually begins with your symptoms and a physical examination.

Depending on the suspected extent of the narrowing, investigations may include:

• urine testing

• a urinary flow test

• bladder ultrasound to measure urine left after voiding

• cystoscopy

• urethral imaging.[1,2]

The important question is whether the problem is limited to the opening or forms part of more extensive urethral disease.

How is meatal stenosis treated?

Treatment depends on the cause, severity and whether the narrowing has been treated before.

Guidelines recognise dilation or a procedure to enlarge the opening as options for selected first-time, uncomplicated meatal strictures. Recurrent narrowing, lichen sclerosus, previous hypospadias surgery or narrowing extending further into the urethra may require reconstructive procedures such as meatoplasty or urethroplasty.[1–3]

Repeated dilation is not always a durable solution, particularly when significant inflammatory scarring is present.[3,4]

A reconstructive assessment can help determine which options are appropriate for the individual anatomy.

Learn more: Penile, Genital & Urinary Reconstruction

When should I seek medical review?

Arrange assessment if you notice progressive narrowing, persistent spraying, a weaker stream, straining, recurrent infections or increasing difficulty passing urine.

If you become unable to pass urine at all, seek urgent medical care.

Patients travelling from interstate or overseas can bring or provide previous operative reports, urethral imaging, pathology and details of earlier treatments to assist assessment and planning.

International Patient Information | Book an Appointment

References

1. European Association of Urology. EAU Guidelines on Urethral Strictures. Arnhem: EAU Guidelines Office; 2026.

2. Wessells H, Morey A, Souter L, Rahimi L, Vanni A. Urethral stricture disease guideline amendment (2023). J Urol. 2023;210(1):64–71. doi:10.1097/JU.0000000000003482.

3. Karsenty G, Morel-Journel N, Fourel M, Neuville P, Freton L, Marcelli F, et al. Treatment of male anterior urethra strictures: meatus, navicular fossa and penile urethra. Fr J Urol. 2024;34(11):102755. doi:10.1016/j.fjurol.2024.102755.

4. Chung ASJ, Suarez OA. Current treatment of lichen sclerosus and stricture. World J Urol. 2020;38(12):3061–3067. doi:10.1007/s00345-019-03030-z.

5. Kulkarni S, Barbagli G, Kirpekar D, Mirri F, Lazzeri M. Lichen sclerosus of the male genitalia and urethra: surgical options and results in a multicenter international experience with 215 patients. Eur Urol. 2009;55(4):945–954. doi:10.1016/j.eururo.2008.07.046.

6. Barbagli G, Palminteri E, Balò S, Vallasciani S, Mearini E, Costantini E, et al. Lichen sclerosus of the male genitalia and urethral stricture diseases. Urol Int. 2004;73(1):1–5. doi:10.1159/000078794.

Medical disclaimer

This information is general in nature and does not replace individual medical advice. A smaller-appearing urinary opening does not by itself establish a diagnosis of meatal stenosis. Investigation and treatment depend on examination findings, the cause and extent of any narrowing, previous procedures and individual circumstances. Seek urgent medical assessment if you are unable to pass urine or become acutely unwell.