Cystoscopy-assisted percutaneous removal of impacted urethral stone: a case report

Although cystolitholapaxy is possible in children, the instruments are not available everywhere. For tiny impacted urethral stone, an alternate technique is described.

A 3-year-old boy came with retention of urine and dysuria. On examination: bladder was full, suprapubic region was tender, and a stone could be felt at posterior urethra. We planned push back and suprapubic cystolithotomy. After general anesthesia, the stone was pushed back by instillation of lignocaine jelly into the urethra. Then, a cystoscope was introduced, and a stone was found inside the urinary bladder. Under cystoscopic view, a 5 mm laparoscopic port was inserted into the bladder just above the pubic symphysis in the midline. A 5 mm tissue holding forceps was introduced through this port, and the tiny stone was grasped and brought out along with the port. The port site was closed by a single stitch. A penile catheter was kept for 5 days.

The boy did well in the postoperative period, and voiding was normal after removal of the catheter.

Impacted posterior urethral stone can be retrieved by simple percutaneous technique.