| Summary: | Introduction We report the pre‐and postoperative evaluation of small benign prostatic hyperplasia with secondary vesicoureteral reflux using video urodynamics. Case presentation A 57‐year‐old man had been suffering from urinary dysfunction for 10 years and was aware of discomfort in his right back during urination. A prostate volume was 24 mL. Cystoscopy revealed hypertrophy of the middle lobe. Video urodynamics demonstrated storage dysfunction, voiding dysfunction, and Grade 3 right vesicoureteral reflux. We performed transurethral holmium laser enucleation of the prostate. Video urodynamics demonstrated improvements in both storage and voiding functions, and the right vesicoureteral reflux resolved 6 months postoperatively. Conclusion Even a small prostate can cause severe urinary dysfunction. In cases of secondary vesicoureteral reflux associated with bladder outlet obstruction, simultaneous repair of the reflux is not necessary unless there is recurrent pyelonephritis or reflux nephropathy.
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