POCUS to Diagnose a Large Urethral Stone Causing Urinary Retention: A Case Report

Ultrasound is routinely used in the diagnosis of renal calculi and resulting hydronephrosis. However, its utility in the diagnosis and management of urethral calculi is less well understood. The ability to rapidly diagnose urethral calculi using point of care ultrasound (POCUS) would be useful in the emergency department (ED) to improve patient outcomes and avoid more invasive investigations.

This case report presents the occurrence of an obstructed urethral calculus in a 42-year-old male, where POCUS facilitated a prompt and accurate diagnosis. The ability to characterise the size, shape and location of the calculus with the urethra enabled the treating clinicians to avoid further investigations and rapidly treat the obstruction. The stone was removed using artery forceps by the urology team in the ED and POCUS was used afterwards to ensure complete removal and resolution of urinary tract obstruction. Overall, the use of POCUS contributed to the patient's safe management, avoiding radiation exposure and minimising the length of stay in the ED.

POCUS is a useful tool for evaluating suspected urethral stones to assess for location, size and signs of urinary tract obstruction.