title: A unique presentation, and management, of acute urinary retention in a young boy with underlying vesicoureteral reflux.
abstract: Vesicoureteral reflux (VUR) affects ∼1% of children. We present an unusual case of urinary retention secondary to an obstructing urethral stone, underlying reflux, and its management. A 7-year-old boy presenting with acute urinary retention had a palpable penile shaft swelling and patent urethral meatus on examination. Cysto-urethroscopy with a 6.6Fr ureteroscope, due to unavailability of paediatric instruments, revealed an obstructing calculus impacted in the navicular fossa. This was laser fragmented and extracted. Cystoscopy revealed multiple bladder calculi with a patulous right ureteric orifice. Post-operative investigations revealed a small, scarred right kidney (ultrasound), bilateral ureteric reflux (micturating-cystourethrogram), 4 cm by 0.8 cm right ureteric calculus (CT-KUB) and 4% right split renal function (DMSA). Right laparoscopic nephroureterectomy was subsequently performed. Our case highlights the variety with which VUR can present and the effectiveness of a ureteroscope in an emergency setting as an alternative to a paediatric cystoscope to visualize the urethra and the bladder.
authors: Department of Urology, City General Hospital, UHNS NHS Trust, Stoke-on-Trent, UK chirag.patel@uhns.nhs.uk.
authors: Chirag
authors: C
authors: Patel
authors: Department of Urology, City General Hospital, UHNS NHS Trust, Stoke-on-Trent, UK.
authors: Vaibhav
authors: V
authors: Modgil
authors: Department of Urology, City General Hospital, UHNS NHS Trust, Stoke-on-Trent, UK.
authors: Christopher
authors: C
authors: Luscombe
authors: Department of Urology, City General Hospital, UHNS NHS Trust, Stoke-on-Trent, UK.
authors: Samson
authors: S
authors: Liu