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Giant Urethral Calculus without Acute Urinary Retention.

Zainal Adwin Zainal Abidin1, Firdaus Hayati2, Guan Hee Tan3

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A man with flank pain had a large urethral stone and a kidney stone. The urethral stone was successfully removed using an endourologic technique, offering relief.

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Area of Science:

  • Urology
  • Nephrology
  • Endourology

Background:

  • Urethral calculi are rare, particularly large, non-obstructing stones.
  • Renal staghorn calculi can coexist with lower urinary tract stones.
  • This case highlights a rare presentation of concurrent upper and lower urinary tract stones.

Observation:

  • A 46-year-old gentleman presented with left lumbar pain.
  • Physical examination revealed a hard mass in the distal urethra.
  • Computed tomography urogram showed a left renal staghorn calculus and a large distal urethral stone.

Findings:

  • The large distal urethral stone was successfully fragmented using an endourologic technique.
  • The patient had no fever or dysuria, and laboratory tests were normal.
  • The concurrent renal staghorn calculus was noted but not the focus of immediate intervention.

Implications:

  • Endourologic techniques are effective for managing large urethral stones.
  • Concurrent upper and lower urinary tract calculi require careful diagnostic evaluation.
  • This case contributes to the understanding of rare stone presentations and management.