Hidden Link Between Meatal Stenosis and Primary Nocturnal Enuresis in Children

Primary nocturnal enuresis (PNE) is a prevalent pediatric condition characterized by involuntary urination during sleep in children aged five years or older who have never achieved consistent nighttime dryness. The prevalence of PNE decreases with age, affecting approximately 15% of five-year-old and decreasing to 1-2% by adolescence.

Meatal stenosis, defined as the pathological narrowing of the urethral meatus, is an underexplored potential factor. This condition is known to cause obstructed urinary flow, incomplete bladder emptying, and increased bladder pressure, all of which may contribute to enuresis.

The incidence of meatal stenosis is higher in circumcised males but can also occur in uncircumcised males and females due to inflammation, trauma, or infection

Inclusion criteria

• Male children aged 7-12 years.
• Diagnosed with primary nocturnal enuresis.
• Evaluated and treated at the study center between January 2021 and December 2024.
• Confirmed diagnosis of meatal stenosis based on clinical examination and uroflowmetry when indicated.
• Patients who underwent meatoplasty and completed the prescribed follow-up period.

Exclusion criteria

• Secondary enuresis (previously dry for ≥ 6 months before recurrence of bedwetting).
• Known neurological disorders (e.g., spina bifida, cerebral palsy) or developmental delays.
• Structural anomalies of the urinary tract other than meatal stenosis (e.g., posterior urethral valves, vesicoureteral reflux).
• Children who did not complete the follow-up or had incomplete clinical records.