Distal ureteral stone in a duplicated system causing urinary retention

Area of Science:

• Urology
• Nephrology

Background:

• Ureteral calculi and urinary retention are common urological issues, but rarely occur together.
• This case highlights a unique presentation of ureteral stone disease leading to significant urinary retention.

Observation:

• A 40-year-old female presented with urinary retention due to a large ureteral stone (2x6 cm).
• The stone originated from an ectopic upper pole ureter within a completely duplicated system and extended into the urethra.
• The patient experienced voiding difficulties, necessitating manual manipulation of the stone.

Findings:

• The ureteral stone was successfully managed using cystoscopy and electrohydraulic lithotripsy.
• Chemical analysis identified calcium phosphate and struvite as the primary components of the stone.

Implications:

• This case underscores the importance of considering rare anatomical variations in the management of ureteral calculi.
• Prompt diagnosis and intervention are crucial for resolving urinary retention caused by obstructive ureteral stones.
• Understanding stone composition can aid in preventing recurrence.