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Bladder Stone Incarceration in Posterior Urethral Valve Leading to Urinary Retention: A Case Report
Limin Huang1, Fei Liu1, Yanfei Wang2
1Department of Nephrology, National Clinical Research Center for Child Health, The Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Insights
Posterior urethral valves (PUV) and bladder stones can cause urinary retention in children. A rare case highlights a stone obstructing a PUV, requiring laser treatment for both conditions.
Area of Science:
- Pediatric Urology
- Medical Case Reports
Background:
- Posterior urethral valves (PUV) and bladder stones are common causes of obstructive lower urinary symptoms in children.
- A combination of PUVs and bladder stones can lead to intermittent urinary retention.
- The association between PUVs and bladder calculus is rarely reported.
Purpose of the Study:
- To present a case of intermittent urinary retention caused by a bladder stone obstructing a PUV.
- To highlight the diagnostic and therapeutic approach for this rare condition.
Main Methods:
- A computed tomography (CT) scan was used to diagnose a bladder stone obstructing the PUV.
- Holmium:YAG laser was employed for intracorporeal lithotripsy of the calculus and fulguration of the PUV.
Main Results:
- The patient presented with a month of intermittent urinary retention.
- CT scan confirmed a bladder stone in the posterior urethra obstructing the PUV.
- Successful treatment was achieved using holmium:YAG laser for both stone removal and valve ablation.
Conclusions:
- Intermittent urinary retention in boys warrants thorough urethral assessment.
- Voiding cystourethrography may not exclude PUVs; bladder endoscopy may be necessary.
- Endoscopy aids in ruling out vesical calculus and identifying potential PUVs.
Introduction:
Posterior urethral valve (PUV) and vesical calculus are individually among the most common causes of obstructive lower urinary symptoms in children. Intermittent urinary retention can be caused by a combination of PUVs and bladder stones. There are very few reports of an association between PUVs and bladder calculus.
Case Presentation:
We present a case of intermittent urinary retention resulting from a stone obstructing the PUV. The patient experienced intermittent urinary retention for over a month. A computed tomography scan revealed a bladder stone in the posterior urethra. The intracorporeal lithotripsy for calculus with fulguration of the PUV was performed using holmium:YAG laser.
Conclusion:
For any boy presenting with urinary retention, we recommend a thorough urethral assessment; the absence of significant abnormalities in the urethra on voiding cystourethrography cannot rule out the presence of relevant PUV; hence, bladder endoscopy may sometimes be required for further evaluation, to rule out vesical calculus and potential PUVs.
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