Balanitis xerotica obliterans with urethral stricture after hypospadias repair

Three cases of urethral stricture due to balanitis xerotica obliterans (BXO ) after hypospadias repair are reported. The first patient showed white, de nse scarring on the prepuce before the hypospadias repair and developed a s tricture of the urethra after the operation. The second and the third were uneventful for 6 and 2 years, respectively, after the hypospadias repair, a nd then developed urethral strictures. Pathologic diagnosis of the stenotic lesion is essential. Complete excision of the affected urethra with topica l steroid ointment or sublesional triamcinolone injection is recommended fo r this condition. Although the complication of BXO after hypospadias repair is rare (3 out of 796 cases with hypospadias in our series), surgeons need to be aware of this condition as a cause for late onset of urethral proble ms.