title: Meatal Occlusive Disease in Adult Males: Are There Any Clinical Variations?
abstract: 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.
  
  
  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.
  
  
  CONCLUSIONS
  MOD in adult males consists of 2 separate clinical entities with different therapeutic outcomes.
authors.affiliation: Department of Urology, King George Medical University, Lucknow, India.
authors.forename: Divakar
authors.initials: D
authors.lastname: Dalela
authors.forename: Piyush
authors.initials: P
authors.lastname: Gupta
authors.forename: Disha
authors.initials: D
authors.lastname: Dalela
authors.forename: Ankur
authors.initials: A
authors.lastname: Bansal
authors.forename: Tuhina
authors.initials: T
authors.lastname: Govil
authors.forename: Apul
authors.initials: A
authors.lastname: Goel
authors.forename: Satya Narayan
authors.initials: SN
authors.lastname: Sankhwar
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D011379:Prognosis; D011446:Prospective Studies; D014525:Urethral Stricture / Q000145:classification* / Q000175:diagnosis / Q000628:therapy