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Published on: April 4, 2025
Impacted urethral stone presenting as urinary retention in a child
Kelly Storm Hoffmann1, Alok Godse2
1Paediatric Surgery, Great North Children's Hospital, Newcastle Upon Tyne, UK kelly.hoffmann@nhs.net.
Insights
Urethral stones are rare in children but can cause urinary retention. This case highlights the importance of considering urethral stones in pediatric patients with urinary symptoms.
Area of Science:
- Pediatric Urology
- Nephrolithiasis
Background:
- Urinary tract infections (UTIs) are common in children.
- Pyelonephritis, a severe UTI, requires prompt treatment.
- Urethral stones are an uncommon cause of urinary retention in pediatric patients.
Observation:
- A 7-year-old boy presented with urinary retention and failed urethral catheterization.
- Cystourethroscopy revealed an impacted urethral stone.
- A suprapubic catheter was placed due to the inability to dislodge the stone.
Findings:
- Investigations identified a pure calcium oxalate stone of secondary origin.
- The patient experienced no recurrence of urethral stones during a 6-month follow-up period.
Implications:
- Urethral stones should be considered in the differential diagnosis of pediatric urinary retention, hematuria, or abdominal pain.
- This case underscores the importance of thorough evaluation in pediatric urinary emergencies.
Abstract:
A seven-year-old boy was referred to our Accident and Emergency department with a history of urinary retention secondary to urinary tract infection and an inability to pass a urethral catheter. He had been treated a month before for suspected pyelonephritis by the referring hospital. Attempts at urethral catheterisation failed, and he was taken to theatre for cystourethroscopy and catheter placement. At this time, an impacted urethral stone was discovered. Because it could not be dislodged, a suprapubic catheter was placed, and the child was brought back at a later date for definitive management. Investigations revealed a pure calcium oxalate stone that was secondary in origin. There has been no recurrence during a follow-up period of 6 months.This illustrates that while rare, urethral stones do occur in children and should be considered in children presenting with urinary retention, haematuria and/or abdominal pain.
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