Meatoscopy: a simple technique to examine the distal anterior urethra in men.

A common problem is to determine the site of the base of meatal warts in men and if the lesions will be suitable for the treatments available in genitourinary medicine (GUM) or sexually transmitted diseases (STD) clinics. Formal endoscopy requires sterile conditions and is therefore an expensive procedure. A simple safe cheap alternative is meatoscopy using an auroscope with inflation. This allows inspection of the anterior urethra to a depth of 5 or 6 cm. With this technique 175 examinations were performed on 153 patients. Warts were confined to the lips in 27 (56%) of 48 patients with meatal warts; in an additional 5 patients with meatal warts the warts arose from deep in the fossa navicularis and in 16 patients with meatal warts there were additional warts in the fossa navicularis invisible on clinical examination. No urethral warts were seen in 103 patients without meatal warts, comprising 47 patients with external genital warts and 56 without any warts. It is concluded that meatoscopy should be undertaken in all patients with meatal warts to determine the site of their base and to assess if there are any more proximal warts. This should be done as soon as the meatal warts are seen, and urethritis has been excluded, so that appropriate treatment can be planned.