Distal ureteral stone in a duplicated system causing urinary retention

Ureteral calculi and urinary retention are common problems encountered by the urologist. However, they rarely occur concomitantly. Herein, we describe a case of a 40-year-old female patient who developed urinary retention as a result of ureteral stone disease. Specifically, an ectopic upper pole ureter in a completely duplicated system contained a 2 x 6-cm ureteral stone, which emanated from the orifice, filling the urethra. The stone caused voiding difficulties to the extent that the patient had to manipulate the stone manually in order to void. The stone eventually resulted in urinary retention. Management was accomplished by cystoscopy and electrohydraulic lithotripsy of the stone. Chemical analysis revealed calcium phosphate and struvite as the principal components of the stone.