Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Urol. Aug 9, 2023; 12(2): 10-16
Published online Aug 9, 2023. doi: 10.5410/wjcu.v12.i2.10
Phallic rubber band application to prevent enuresis unusual cause of urethral stricture in a child: A case report
Abdullahi Khalid, Musa Nasiru, Abdullahi Abdulwahab-Ahmed, Abubakar Sadiq Muhammad, Ngwobia Peter Agwu, Christopher Suiye Lukong
Abdullahi Khalid, Abdullahi Abdulwahab-Ahmed, Abubakar Sadiq Muhammad, Ngwobia Peter Agwu, Department of Surgery, Tetfund Centre of Excellence in Urology and Nephrology, Institute of Urology and Nephrology, Usmanu Danfodiyo University and Teaching Hospital, Sokoto 840000, Nigeria
Musa Nasiru, Christopher Suiye Lukong, Department of Surgery, Paediatric Surgery Unit, Usmanu Danfodiyo University and Teaching Hospital, Sokoto 840000, Nigeria
Author contributions: All the authors were responsible for the design and implementation of the research; Khalid A, Nasiru M, and Abdulwahab-Ahmed A conceptualized this study and acquired the data; Khalid A, and Nasiru M made the initial draft of this work; Abdulwahab-Ahmed A, Muhammad AS, and Agwu NP contributed to the revision of the initial draft; Agwu NP and Lukong CS added additional inputs to the initial draft; Abdulwahab-Ahmed A, Lukong CS, and Agwu NP critically revised and made a major contribution to the intellectual content of the final manuscript; All authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare that they have no conflict of interest to disclose.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Abdullahi Khalid, MBBS, Surgeon, Department of Surgery, Tetfund Centre of Excellence in Urology and Nephrology, Institute of Urology and Nephrology, Usmanu Danfodiyo University and Teaching Hospital, No. 1 Garba Nadama Road, Gawon Nama, Sokoto 840000, Nigeria. kalabduka@gmail.com
Received: April 16, 2023
Peer-review started: April 16, 2023
First decision: June 12, 2023
Revised: June 21, 2023
Accepted: July 7, 2023
Article in press: July 7, 2023
Published online: August 9, 2023
Processing time: 112 Days and 20.9 Hours
Abstract
BACKGROUND

Urethral stricture is the abnormal narrowing of the urethra due to spongiofibrosis. The established aetiological factors for urethral stricture abound in our environment. However, the application of a penile rubber band to prevent enuresis thereby causing this pathology is not a familiar occurrence. Patients with enuresis can suffer psycho-social challenges and trauma, especially for a child due to peer stigmatization. This has a great impact on the child's psyche and may affect even his performance at school. The aim of this paper is to highlight the psychosocial impact and management challenges of a child with enuresis (nocturnal urinary incontinence).

CASE SUMMARY

This is the case of a 10-year-old boy who presented with a history of nocturnal urinary incontinence since birth and lower urinary tract symptoms (LUTS) for 3 years culminating in chronic urinary retention. He maintained a normal urge to micturate and continent of urine during the daytime before the onset of LUTS. He had an antecedent longstanding history of tying a rubber band to the penile shaft mostly before going to the bed at night to prevent enuresis due to his peer stigmatization. He was acutely ill-looking, with distended suprapubic region. The phallus and scrotum were enlarged and oedematous with a circumferential proximal penile shaft scar and ventral penile shaft urethrocutaneous fistula. He was diagnosed to have complete short segment bulbopenile stricture and right ectopic ureter. He subsequent had augmented anastomotic urethroplasty and bilateral non-refluxing ureteroneocystostomy at different sitting.

CONCLUSION

The adherence to surgical principles of urethral stricture and enuresis management where surgically correctable in a child is associated with the resolution of enuresis and social reintegration.

Keywords: Enuresis; Double ureter; Ectopic ureter; Rubber band; Urethral stricture; Case report

Core Tip: Enuresis is a psycho-socially challenging and emotionally traumatic condition. This paper brings to light the management of secondary nocturnal enuresis in a 10-year-old male child with an attendant urethral stricture. A complication resulting from the longstanding application of rubber band to the penile shaft to prevent enuresis and stigmatization by his peers. The clinical presentation of this case is clouded by the clinical features of the dual pathology. Hence, a step-wise application of the surgical principle of clinical evaluation, laboratory and imaging investigations and surgical treatment is associated with resolution of enuresis and patient satisfaction.