Anterior deflected urinary stream

We present a case of anterior deflected urinary stream (ADUS) secondary to meatal shelf with no dysfunctional voiding symptoms (DV). The video illustrates the presentation, operative management and literature review. Meatal deformity in girls has been described in association with DV. Hoebeke et al. highlighted the strong correlation between meatal abnormality and non-neurogenic bladder dysfunction in girls. They demonstrated that girls with ADUS had more severe dysfunction on urodynamics. Klijn et al. prospectively evaluated the effect of surgical meatal correction in girls with ADUS. They found that 39% of female patients with DV had ADUS, 50% of them were free of symptoms following surgical correction. This is the first reported case of an isolated ADUS without DV. Early correction of the anomaly is advocated to limit social distress, and potentially prevent development of DV.