To evaluate the success of meatoplasty for isolated meatal stenosis following hypospadias repair and identify factors associated with recurrence.

We reviewed all patients who underwent meatoplasty for meatal stenosis following hypospadias repair at a tertiary center during 2000-2024. Data were collected from clinical records and telephone interviews. Outcomes included surgical success (symptom resolution without reintervention) and time to recurrence. Associations with variables (age, hypospadias severity) were analyzed.

Among 112 eligible patients, 63 met inclusion criteria (consented with adequate follow up). One meatoplasty was curative in most cases; 45 patients (71.4%) required one meatoplasty, while 18 (28.6%) developed recurrent stenosis and underwent a second meatoplasty. The median age at primary hypospadias repair was 17 months (IQR 9-36), and the median age at first meatoplasty was 3.8 years (IQR 2.5-6.7). Baseline characteristics and age at first meatoplasty did not significantly differ between those with and without recurrence ( P > .05). The median interval from first to second meatoplasty was 3.5 years (range 0.2-13.7). Recurrence timing showed a bimodal pattern: ∼28% occurred within 1 year and ∼39% at ≥5 years post meatoplasty. All patients were symptom free after reoperation, and none of the patients needed further intervention.

Meatoplasty is an effective treatment for meatal stenosis after hypospadias repair. No clear predictive factors for recurrence were identified. Even late presenting recurrences were successfully managed with repeat meatoplasty, highlighting the need for prompt intervention and extended surveillance into adolescence.