Introduction:

Congenitalurethral stenosis in boys occurs at the junction of the entodermal primary urethra and ectodermal secondary urethra. Endoscopically, this lesion is recognized as a ring-form stenosis just below the external urethral sphincter. It has been considered as rare acongenitalanomaly. The most effective treatment of this lesion is transurethral incision.

We present a case of congenital urethral stricture in childhood in order to highlight the existence of this disease and the importance of an early treatment.

Case report:

A 5-year-old boy was referred to our department for weak stream and Urinary incontinence. The patient was resistant to conservative therapy, including medical treatment and behavioral therapy. There was no previous history of instrumentation or of urinary tract infection. Underwent voiding cysto-urethrography showed prostatic urethral dilatation and narrowing bulbar lesion. Vesico-ureteral reflux (VUR) grade III was also observed. After confirming the diagnosis ofurethral stricture, endoscopic urethrotomy was performed under general anesthesia. After the operation, day time incontinence was resolved and nocturnal enuresis became controllable with or without anticholinergic drugs . The urinary stream and VUR was improved. On postoperative voiding cystography, the urethra was dilated and VUR were improved. The procedure was well tolerated and the boy was discharged home the next day. There were no major complications related to the operation. He was followed-up regularly every 23 months after surgery.

Conclusion :

Congenital urethral stenosis is an irnportant clinical entity in pediatric urology. It is not such a rare disease. We must note the existence of this disease, especially in boys suffering drug resistant diurnal incontinence. Early endoscopic intervention is safe and feasible and its short-term clinical outcomes are very favorable. Long-term clinical outcomes, however, remain to be investigated.