A 4-year-old boy is brought to the pediatric clinic by his parents after they noticed that he has had difficulty urinating for the past few days. The child is complaining of a weak urine stream, which sometimes dribbles and takes longer than usual. His parents also report that he has been crying in pain when trying to urinate and has had occasional urinary retention.

On examination, the child appears well-hydrated but is noticeably uncomfortable during the physical exam. There is no visible abnormality in the genital area, but further assessment suggests a congenital non-meatal urethral stricture, a condition in which the urethra is narrowed at a site other than the meatus (the external opening), obstructing normal urine flow.

A voiding cystourethrogram (VCUG) is ordered, and it confirms the diagnosis of a urethral stricture, revealing a narrowed segment of the urethra. The pediatric urologist is consulted for further evaluation and management. The family is counseled about the condition, which may require surgical intervention to relieve the obstruction and restore normal urinary function. Depending on the severity of the stricture, the child may require a urethral dilation procedure or even a more complex reconstructive surgery.

A follow-up plan is established to monitor the child’s progress and plan for the appropriate intervention.