We present a case report of a 13-year-old boy with undiagnosed balanitis xerotica obliterans (BXO), resulting in urinary retention,paradoxical ischuria, and difficult placement of indwelling urinary catheter. Total circumcision with ventral and dorsal meatotomywas completely curative, with no need for local corticosteroids.
BXO is a neglected and underestimated diagnosis in boys. Despitebeing the most common cause of secondary pathological phimosis in boys, BXO is often considered to be scarring phimosis onlyand mistakenly indicated for partial circumcision by some paediatric specialists.