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Urethral calculi.

S C Paulk, A U Khan, R S Malek

    The Journal of Urology
    |October 1, 1976
    PubMed
    Summary
    This summary is machine-generated.

    Urethral calculi, or stones in the urethra, are often migratory and linked to underlying urinary tract issues. Management involves endoscopic removal and addressing potential metabolic causes for better patient outcomes.

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    Area of Science:

    • Urology
    • Nephrology

    Background:

    • Urethral calculi are stones that form in the urethra, causing significant lower urinary tract symptoms.
    • A majority of patients present with dysuria, weak stream, and perineal pain.
    • Prevalence is higher in men, often associated with lower urinary tract lesions or prior prostatic surgery.

    Purpose of the Study:

    • To review the diagnosis and management of urethral calculi in a cohort of male and female patients.
    • To identify common presenting symptoms, diagnostic challenges, and etiological factors.
    • To evaluate the efficacy of various surgical interventions and long-term outcomes.

    Main Methods:

    • Retrospective review of 34 men and 13 women diagnosed with urethral calculi.
    • Analysis of presenting symptoms, radiographic and cystourethroscopic findings.

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  • Documentation of surgical procedures, including transurethral removal, endoscopic guidance, litholapaxy, cystolithotomy, and diverticulectomy.
  • Investigation for metabolic causes in a subset of patients.

    • Main Results:

    • Radiographic diagnosis was achieved in only 42% of patients, while cystourethroscopy confirmed calculi in all cases.
    • Migratory urethral calculi were ten times more frequent than native stones.
    • Metabolic causes were identified in 10 of 18 studied patients.
    • Transurethral removal, endoscopic guidance, and litholapaxy were primary methods for men; women's calculi were removed during diverticulectomy.
    • A majority of followed patients (76.5% of men and 4 women) remained asymptomatic post-treatment.

    Conclusions:

    • Cystourethroscopy is crucial for accurate diagnosis of urethral calculi.
    • Migratory stones and underlying metabolic or anatomical factors are significant considerations.
    • Endoscopic management is effective for most urethral calculi, with high success rates and low recurrence.
    • Surgical intervention tailored to stone location and patient characteristics leads to favorable long-term outcomes.