Refractory nocturnal enuresis associated with bulbar urethral stricture successfully treated by non-transecting urethroplasty

Introduction: Urethral obstruction has been reported to be involved in the pathogenesis of nocturnal enuresis, but such patients have been treated only endoscopically. We report a case in which nocturnal enuresis was successfully treated by an urethroplasty. Case presentation: A 13-year-old boy was referred to our hospital for nocturnal enuresis, which was refractory to desmopressin acetate, anticholinergic drugs, and alarm therapy. Video urodynamic study findings showed bladder outlet obstruction associated with a short bulbar stricture. Two attempts to relieve the obstruction by direct vision internal urethrotomy improved enuresis, albeit transiently. A non-transecting urethroplasty was performed at the age of 15 years, which resulted in dramatic and durable improvements in enuresis, maximal flow rate in uroflowmetry, as well as other urodynamic parameters. Conclusion: Urethroplasty, preferably by a non-transecting technique, can be a viable treatment option for intractable nocturnal enuresis associated with non-traumatic and short bulbar urethral stricture upon completion of puberty.