[A case of true phimosis with bilateral hydroureteronephrosis and bilateral vesicoureteral reflux]

A 12-year-old boy presented with nocturnal enuresis. He could not void in a stream and urine dropped out of the external urethral orifice. Physical examination revealed the stenosis of prepuce and balanoposthitis. An intravenous pyelogram and a cystogram showed bilateral hydroureteronephrosis and bilateral vesicoureteral reflux. He was diagnosed with severe true phimosis complicated with bilateral hydroureteronephrosis and bilateral vesicoureteral reflux. His balanopothitis was treated with antibiotics for a few days. Dorsal slit of prepuce and release of adhesion between glans and prepuce were subsequently performed. Four months after operation, an intravenous pyelogram revealed regression of hydronephrosis. Bilateral vesicoureteral reflux was not observed on the cystogram. The possibility of upper urinary tract involvement must be considered in patients with true phimosis and dysuria.