Meatus Knife

I have been reading a medical book from around 1890, the text mentions *meatus knife* a few times. Does anyone know what characteristics a meatus knife might have? Urological meatus.

Is it a serrated knife, which means one with teeth or a sawtooth blade? Like a bread knife, but hopefully much smaller?

Has anyone heard this term used before?

Thanks.

Closest I found was a meatotomy knife used to open the meats to improve urinary flow. One modern version is an Otis knife that has a conical head vs a sharp point to enten the urethra without cutting the urethra itself I don’t think a meatus knife was used for circumcisions

https://ucipediatricurology.com/specialties/meatotomy/#:~:text=A%20meatotomy%20is%20a%20simple,it%20may%20cause%20him%20pain.

Thank you, that was helpful.

"What’s the difference between meatotomy and meatoplasty?

Meatoplasty is done by opening the glans — the tip of the child’s penis — with an incision, and using sutures to stitch together the edges of the area that was opened. This helps widen the area around the meatus in order to make peeing easier. This may also result in a much larger hole for urine to come out.

Meatotomy is simply the procedure of making the opening of the meatus larger. Stitches may not be used in a meatotomy, and the surrounding tissue may not be modified at all."

In the surgery guide [quack] I'm reading, the meatus knife was used as an additional step in male circumcision. I wonder how many of these patients died from what would be seen as very minor infections today. In the photographs in the book the multiple surgeons have bare hands and hair on the backs of their hands (dorsal aspect of the hand).

The more I read about surgery in the 19th Century the more I appreciate today's medicine.

The more I read about surgery in the 19th Century the more I appreciate today's medicine.

No kidding! Worse yet, think about battlefield surgery during the civil war!

No kidding! Worse yet, think about battlefield surgery during the civil war!

Worse yet, think about surgery tout court before the Civil War. At least chloroform was used (now and then). Prior to that does not really bear thinking about ...

@SnuggleGuy

Use of the meatal knife is described in Pratt's "Orificial Surgery" book where he proposed for both male and female patients the surgery of genital and anal orifices as main treatment for a plethora of chronic diseases.

He described in detail the male sexual system surgery reccomanding the dorsal slit of the prepuce and the circumcision on his male patients with a specific detail on the last part of the surgery after the removal of the frenulum: "Before the foreskin is closed over the glans penis, the meatus urinarius should also be examined, and if found to present a constricted condition, should be enlarged with a meatus knife to the full caliber of the urethra. The introduction of bulbous sounds will accurately define this point. The incision of the meatus should always be made at its lower edge."

The meatal knife is a thin and long sharp metal blade instrument with an handle that was inserted in the glans meatus cutting open the orifice.

I remember seeing the instrument in one of the old surgical textbooks, but I do not have an image of it. It resembled a short urethral sound, with a trapezoidal blade protruding from the tubular portion beyond its long, blunt, rounded tip. The width of the blade gradually increased from about 1 mm at its narrowest point to approximately 10-12 mm at its end. The blunt tip allowed for steady positioning before the blade is inserted into the urethra, providing better control over the depth at which the blade was inserted and the meatus is slit. A gentle tapping on the instrument likely resulted in the lengthening of the meatus by a few millimeters. But, if the device was inserted to the full depth of its blade, it not only slit the meatus to the width of the blade but also widened the urethra.

I also remember reading that patients were often hospitalized after a meatotomy, and post-operative instructions included keeping the meatus packed with surgical gauze for extended periods.

Please don’t try this at home

There's a gory rite of passage in aborigines Australia (maybe elsewhere) called subincision. A teen is bent backwards over a log, and the urethra is opened from the meatus to the base of the penis. Now that's a 'meatotomy'!! A number of 'body modifiers' do the same thing to themselves. I've seen online photos of total subincision like the abo's do.

One supposes that strictures can occur anywhere, either from infection, trauma, or congenital (in babies). Slice open the small hole, pee better. Slice it too much and the urine stream sprays all over the place and one has to sit down to pee.

I’ve read that one of the complications of infant circumcision - not rare but not common either - is stenosis (narrowing) of the meatus. This happens due to the exposed orifice getting irritated. Wonder if such “meatus knives” were used to fix that back then.