Urine stream deflected forward/upward.

My 4 1/2 year old son's urine stream is deflected forward/upward, but he doesn't seem to strain or have any problems urinating or any pain.  I think it may be meatal stenosis, but had some questions before I see a pediatric urologist.  I also wasn't sure if it was getting better on it's own.  Can you please tell me if this is something that can be "outgrown" and if it's likely to go away on it's own.  Also, if a procedure is required, what age is it typically recommended... is it better to take him now or wait til he's a little older?  On a similar topic, his penis also seems to be slightly rotated to one side... is that normal, or should that be evaluated too... could he outgrow that as well?  Thanks

[Dr J Singh]

Hi,
A slight curve of the penis is normal and you shouldn’t worry about the same and it’s fine. However, you need to be worried about the abnormal stream of the urine going upwards. It can occur in meatal stenosis but in this condition the child also has other symptoms like burning micturition,pain,fine stream,difficulty aiming the stream etc. I’ll suggest you to visit a urologist and consult. If meatal stenosis is present, then a very simple procedure known as meatotomy is done and should be done as early in life as possible to avoid back pressure damage to the kidneys.
Another possibility is of an abnormal opening of the meatus, for which a physical examination is a must and again requires a surgical procedure for correction.
Hope that helps. Please do keep me posted. Kind Regards.