Urethral Lithiasis Causing Acute Retention of Urine

Abstract

Calculi in the male urethra are rare and are generally associated with urethral disorder. Treatment is generally by extraction and resolution of the underlying cause. We report a case of urethral calculus, in a man with lithiasis emission history, of apparentlyrelated to his pathologies of gout and diabetes that had treated by forceps extraction.

Introduction

Urethral calculi are rare in the western hemisphere and fairly common in oriental and developing countries, detailed reports are few [1]. This pathology causes pain, dysuria or urinary retention and most patients require urgent treatment. We report the diagnosis and treatment of an adult admitted to urological emergencies for acute retention of urine.

Case Report

Mr. K.M, 51 years old, the patient is known diabetic under metformin and glimepiride, followed for gout disease, admitted to the emergency room for acute urine retention. He says he presented two days previously right lumbar pain. Examination had found a conscious patient, in good general state and hemodynamic, agitated with the presence of a hypogastric renitence (distended bladder). The urethral meatus was edematous with palpation a stony hard mass fixed. The rest of the penis was normal. The urinary catheterization was impossible.

A suprapubic puncture was performed urgently to relieve the patient. X-ray of the urinary shaft without preparation and an x-ray centered on the penis (Figure 1) allowed finding an opacity projecting at the level of the penile urethra. Local anesthesia by lidocaine injected through the urethral meatus was made; the lithiasis was extracted by a fine Bengolia forceps without incident. A bladder catheter was left in place for 7 days. The suites operating posts were simple, Renal and vesico-prostatic ultrasound done after a week was normal. Thirteen months later, from our patient benefited a right flexible ureteroscopy for average callial lithiasis of 6mm, and he had no recurrence of urethral lithiasis or sign of low urinary tract.