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A stone down below: a urethral stone causing acute urinary retention and renal failure

Published online by Cambridge University Press:  21 May 2015

Hanna Bielawska  and
Norman L. Epstein
Hanna Bielawska*
Affiliation:
Emergency Department, Credit Valley Hospital, Mississauga, Ont.
Norman L. Epstein
Affiliation:
Emergency Department, Credit Valley Hospital, Mississauga, Ont.
*
Emergency Department, Credit Valley Hospital, 2200 Eglinton Ave. W., Mississauga ON L5M 2N1; hanna.bielawska@utoronto.ca

Abstract

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Impaction of a kidney stone in the male urethra is a rare sequela of an otherwise common disease process. Case reports of urethral stones in the recent literature are scarce. We report a case of a 48-year-old man who presented with an impacted urethral stone as a complication of nephrolithiasis. The pathology was twice missed, even with computed tomography showing the stone in the prostatic urethra, which highlights the challenges of making this diagnosis. We review the existing literature outlining the pathogenesis, clinical features and therapeutic considerations as they relate to urethral stones. We underscore the role of the emergency physician in the diagnosis and initial management of this entity, and draw attention to the need to evaluate not just the upper but also the lower genitourinary tracts when interpreting computed tomographic images obtained for the diagnosis of renal colic.

Keywords

renal colicurethral stonecomputed tomographic urography
Type
Case Report • Rapport de cas
Information
Canadian Journal of Emergency Medicine , Volume 12 , Issue 4 , July 2010 , pp. 377 - 380
Copyright
Copyright © Canadian Association of Emergency Physicians 2010

References

REFERENCES

1.Khai-Linh, VH, Segura, JW. Chapter 84: Lower urinary tract calculi. In: Wein, AJ, Kavoussi, LR, Novick, AC, et al, editors. Campbell’s urology. 9th ed. St. Louis (MO): Saunders Elsevier; 2007.Google Scholar
2.Gogus, O, Isikay, L, Yaman, O, et al.An usually large anterior urethral stone. Br J Urol 1995;76:801–2.Google Scholar
3.Verit, A, Savas, M, Ciftci, H, et al.Outcomes of urethral calculi patients in an endemic region and an undiagnosed primary fossa navicularis calculus. Urol Res 2006;34:37–40.Google Scholar
4.Hemal, AK, Sharma, SK. Male urethral calculi. Urol Int 1991; 46:334–7.Google Scholar
5.Kamal, BA, Anikwe, RM, Darawani, H, et al.Urethral calculi: presentation and management. BJU Int 2004;93:549–52.Google Scholar
6.Durazi, MH, Samiei, MR. Ultrasonic fragmentation in the treatment of male urethral calculi. Br J Urol 1988;62:443–4.Google Scholar
7.Suzuki, Y, Ishigooka, M, Hayami, S, et al.A case of primary giant calculus in female urethra. Int Urol Nephrol 1997;29:237–9.Google Scholar
8.Thompson, B, Hardwood-Nuss, AL. Urolithiasis in a child: an uncommon presentation of an uncommon disease. Ann Emerg Med 1995;25:837–40.Google Scholar
9.Ginesin, Y, Bolkier, M, Nachmias, J, et al.Primary giant calculus in urethral diverticulum. Urol Int 1988;43:47–8.Google Scholar
10.Kaplan, M, Atakan, IH, Kaya, E, et al.Giant prostatic urethral calculus associated with urethrocutaneous fistula. Int J Urol 2006;13:643–4.Google Scholar
11.Koga, S, Shiraishi, K, Saito, Y, et al.Sonography of urethral calculi. Urol Int 1993;50:203–4.Google Scholar
12.Villaume, F IV, Plummer, D, Caroon, L. Diagnosis and removal of urethral calculi using bedside ultrasound in the emergency department. Acad Emerg Med 2009;16:1031–2.Google Scholar
13.Sharma, A. Unenhanced helical CT in renal colic. Internet Journal Radiology 2005;4:1.Google Scholar
14.Aguilera, PA, Choi, T, Durham, BA. Ultrasound-guided suprapubic cystostomy catheter placement in the emergency department. J Emerg Med 2004;26:319–21.Google Scholar
15.El-Sherif, AE, Prasad, K. Treatment of urethral stones by retrograde manipulation and extracorporeal shock wave lithotripsy. Br J Urol 1995;76:761–4.Google Scholar
16.Dasgupta, HK, Gupta, VV. Tube-bouginage technic in the management of urethral stone (case reports). J Postgrad Med 1981;27:187–188b.Google Scholar
17.Al-Ansari, A, Shamsodini, A, Younis, N, et al.Extracorporeal shock wave lithotripsy monotherapy for treatment of patients with urethral and bladder stones presenting with acute urinary retention. Urology 2005;66:1169–71.Google Scholar
18.Selli, C, Barbagli, G, Carini, M, et al.Treatment of male urethral calculi. J Urol 1984;132:37–9.CrossRefGoogle ScholarPubMed