International Journal of Clinical Urology

| Peer-Reviewed |

Management of Impacted Urethral Calculi: An Uncommon Cause of Acute Urine Retention in North-western Nigeria

Received: 04 November 2019    Accepted: 12 December 2019    Published: 07 January 2020
Views:       Downloads:

Share This Article

Abstract

Urethral stones though rare manifestation of urolithiasis may be primary but mostly are secondary arising from either the urinary bladder or the upper tract. When impacted in the urethra may result in acute urinary retention and difficulty in urethral catheterization. Various treatment modalities are available ranging from initial suprapubic cystostomy and subsequent open surgical or endoscopic procedures as well as treatment of associated urethral pathology. We report our experience in the management of patients with acute urine retention due to impacted urethral calculi in a tertiary hospital. This was a retrospective review of forty patients with impacted urethral stones managed at the Urology Unit, Department of Surgery Usmanu Danfodiyo University Teaching Hospital Sokoto from January 2005 to December 2015. Data were collected from patients’ case notes and entered in to a proforma and analysed using SPSS 20.0 version for Windows. Forty patients comprising of one female (2.5%) and 39 males (97.5%), mean age was 25±17.4 years with a range of 1-63yrs. In twenty patients (50%), attempt at urethral catheterization was not successful. Location of the impacted calculi were meatal 7 (17.5%), distal penile 4 (10%), mid penile 8 (20%), proximal penile 1 (2.5%), bulbar 4 (10%), peno-bulbar junction 3 (7.5%), posterior urethra 11 (27.5%), and bladder neck 2 (5%). Spontaneous extrusion of the calculi occurred in 4 (10%), while expulsion occurred in 2 (5%) after intra-urethral instillation of 2% lidocaine jelly. Other treatment modalities in the remaining patients included; meatotomy 11 (27.5%), open urethrolithotomy 6 (15%), urethroscopy and pneumatic lithotripsy 6 (15%), urethroscopy and stone retrieval 1 (2.5%), urethrolithotomy and urethroplasty 2 (5%), and cystolithotomy 8 (20%). Impacted urethral stone may be a cause of acute urinary retention and failed urethral catheterisation. The stone can pass spontaneously with or without manipulation or can be removed by endoscopic or open technique when spontaneous passage is not successful.

DOI 10.11648/j.ijcu.20200401.11
Published in International Journal of Clinical Urology (Volume 4, Issue 1, June 2020)
Page(s) 1-5
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2024. Published by Science Publishing Group

Keywords

Impacted Urethral Calculus, Acute Urine Retention, Failed Urethral Catheterization and Management

References
[1] Knoll, Thomas. Epidemiology, Pathogenesis and Pathophysiology of Urolithiasis. European Urology Supplement 2010: 9: 802-806.
[2] Tefekli Ahmet, Cezayirli Fatin. The History of Urinary Stones: In Parallel with Civilization. The Scientific World journal, Volume 2013, Article ID 423964, 5 pages. http//dx.doi.org/10.11551/2013/423964.3.
[3] Lopez, Michelle, Hoppe, Bernd. History, epidemiology and regional diversities of urolithiasis. Pediatr Nephrol, 2010; 25: 49-59.
[4] Trinchieri Alberto. Epidemiology of urolithiasis: an update. Clinical Cases in Mineral and Bone Metabolism 2008; 5 (2): 101-106.
[5] Krishna Prasad K, Keerthi N, Praveen GP, Amal Abraham. A rare case of Giant Penile Urethral Calculus. International Journal of Sciences and Research (IJSR) 2016; 5 (9): 532-533.
[6] Agarawal A, Sigdel G, Beloker WK. A rare case of giant urethral calculus and multiple urethral diverticulum. Journal of Medical Sciences- Nepal, 2012; 8 (2): 46-48.
[7] Benway BM, Bhayani SB. Lower Urinary Tract Calculi. In Campbell-Walsh Urology. Ed. Kavoussi LR, Novick AC, Partin AW, Peters CA. 10th Edition, Elsevier Saunders, Philadelphia PA 19103-2899, pages 2529-2532.
[8] Beilawske H, Epstein Norman L. A stone down below: a urethral stone causing acute urinary retention and renal failure. CJEM 2010, 2 (4) 377-380.
[9] Mark FG, Mador ML. Urethral Calculi. Canad MAJ. 1950; 54: 186-188.
[10] Ramdass MJ, Singh VN. Multiple Urethral stones causing Penile gangrene. Case Rep Urol 2014; 1-3.
[11] Akiko Ikegami et al. Iliac vein Compression Syndrome due to Bladder Distension caused by Urethral Calculi. Hindawi Publishing Corporation Case Reports in Urology Volume 22015 Article ID. 743270 3 pages. http//dx.doi.org/10.1155/2015/743270.
[12] Prakash J, Sharma P, Sankhwar S, Goel A. Large anterior urethral calculus presented as scrotal mass with urethrocutaneous fistula. BMJ Case Reports 2013. doi 10.1136/bcr-2013-200805.
[13] Bello A., Maitama HY, Mbibu HN, Kalayi GD and Ahmed A. Unusual Giant Prostatic Urethral Calculus. J. Surgery Tech. Case Report 2010; 2 (1): 30-32 doi: 104103/2006-8808.63721.
[14] Win T. Giant urethral calculus Singapore Med J. 1994; 35: 44-415.
[15] Kotkar K, Thakkar R, Songra MC. Giant Urethral Calculus. JS CR 2011; 8: 9.
[16] Abubakar AM, Mungadi IA, Chinda JY, Ntia IO, Jalo I and Obianno SK. Paediatric urolithiasis in northern Nigeria. African Journal of Paediatric Surgery 2004; 1: 2-5.
[17] Turo F, Smolski M, Kujawa M, Brown SCW, Brough R and Collins NC. Acute urine retention in women due to urethral calculi. A rare case. Can Urol Assoc J 2014; 8 (1-2): 99-10. http//dx.doi.org/105489/cuaj.1573.
[18] Okeke LI, Takure AD, Adebayo SA, Oluyemi OY, Oyelekan AAA. Urethral Obstruction from dislodged bladder Diverticular Stones: a case report. BMC Urology 2012; 12: 3 http://www.biomedicentral.com/1471-2490/12/31.
[19] Speekman MJ, Cheng Xi. Management of Complications of BPH/BOO. Indian J Urol. 2014; 30 (2): 208-213.
[20] Embertom M, Ansner K. Acute urinary retention en men: an age-old problem. BMJ 1999; 3: 92210925.
[21] Roehborn CG. Acute urinary retention risks and management Rev. Urology 2005; (supp/4); 531-542.
[22] Ugare UG, Bassey IA, Udosen EJ, Essiet A. Bassey OO. Management of lower urinary retention in limited resource setting. Ethio J Health Science 2014; 24 (4): 329-336.
[23] Mevche A, Drake MJ. Etiology and management of urinary retention in women. Indian J Urol. 2010; 26 (2): 230-235.
[24] Christodoulidon M, Keba R, Octes J, Wemyss-Holden GD. Acute urinary retention in an adolescent girl and important learing point. BMJ case report 2013. Doi: 10.1136/bcr-2013-010361.
[25] Suzuki S, Ono S and Satomi M. recurrence of urinary retention secondary to retroverted gravid uterus. N AM J Med Sci. 2009. July 1 (2): 54-59.
[26] Tannus SR, Atlas I. Endometrial cancer presenting as AUR: a case report and review of literature cases journal 2009, 2: 9382.
[27] Kamal BA, Anikwe RM, Parahani H, Hashish M Taha SA. (2004). Urethral calculus: presentation and management BJU International 93 (4), 549-502.
[28] Krill AJ, Palmer LS, Palmer JS complications of circumcision Scientific World Journal 2011; 11: 2458-2468.
[29] Nnamonu MT. Circumcision experience at a private Hospital in Jos, Nigeia. Niger J. Surg. 2013; 19: 1-3.
[30] Lawal TA, Olapade-Olaopa EO. Circumcision and its effects in Africa. Transl Androl Urol 2017; 6 (2): 149-157.
[31] Dong ZhiLong, Wang Hanzhang, Zuo LinJung, Hou Minghi. Female Urethral Diverticulum Containing a Giant Calculus. A CARE–Compliant Case Report. Medicine 2015; 94 (20): e826.
[32] Shim JS, Oh MM, Kang J II. Calculi in female urethral diverticulum. Int Neuro-urol J, 2011; 15: 55-58.
[33] Prabhuswanny V K, Tiwari R and Krishnamoorthy R. A Giant Dumbell Shaped Vesico-Prostatic Calculus: A case Report and Review of Literature. Case Reports in Urology, Volume 2013, Article ID 167635, 5 pages, http://doi/ 10.1155/2013/167635.
[34] Akhtar J, Ahmad S, Zamir N. Management of Impacted Urethral Stones in children. Journal of the College of Physicians and Surgeons of Pakistian 2012, 22 (8): 510-513.
[35] El-Sarif, Prasad K. treatment of urethral stones by retrograde manipulation and extracorporeal shock wave lithotripsy. Br J urol. 1995; 76 (6): 761-764.
[36] Kaczmarek K, Goteb A, Soczawa M, Stojewski M. urethral stone of unexpected size: case report and short literarure review. Open Med. 2016; 11: 7-10.
[37] Banapour P, Tenggardaja C, Reyblat P. Anastomotic Urethroplasty for an Obstructing Calculus within a Bulbar Urethral Diverticulum and Stricture. Urology Case Reports 2017; 10: 54-56.
[38] Vashishtha S, Sureka SK, Agarwal S, Srivastava A, Prabhakaran S et al. Urethral stricture and stone: their coexistence and management. Urology Journal 2014; 11: (1): 1204-1210.
Author Information
  • Urology Unit, Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

  • Urology Unit, Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

  • Urology Unit, Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

  • Urology Unit, Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

  • Urology Unit, Department of Surgery, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Nigeria

Cite This Article
  • APA Style

    Ngwobia Peter Agwu, Abdullahi Abdulwahab-Ahmed, Abubakar Muhammadu Sadiq, Emmanuel Ugbede Oyibo, Ismaila Arzika Mungadi. (2020). Management of Impacted Urethral Calculi: An Uncommon Cause of Acute Urine Retention in North-western Nigeria. International Journal of Clinical Urology, 4(1), 1-5. https://doi.org/10.11648/j.ijcu.20200401.11

    Copy | Download

    ACS Style

    Ngwobia Peter Agwu; Abdullahi Abdulwahab-Ahmed; Abubakar Muhammadu Sadiq; Emmanuel Ugbede Oyibo; Ismaila Arzika Mungadi. Management of Impacted Urethral Calculi: An Uncommon Cause of Acute Urine Retention in North-western Nigeria. Int. J. Clin. Urol. 2020, 4(1), 1-5. doi: 10.11648/j.ijcu.20200401.11

    Copy | Download

    AMA Style

    Ngwobia Peter Agwu, Abdullahi Abdulwahab-Ahmed, Abubakar Muhammadu Sadiq, Emmanuel Ugbede Oyibo, Ismaila Arzika Mungadi. Management of Impacted Urethral Calculi: An Uncommon Cause of Acute Urine Retention in North-western Nigeria. Int J Clin Urol. 2020;4(1):1-5. doi: 10.11648/j.ijcu.20200401.11

    Copy | Download

  • @article{10.11648/j.ijcu.20200401.11,
      author = {Ngwobia Peter Agwu and Abdullahi Abdulwahab-Ahmed and Abubakar Muhammadu Sadiq and Emmanuel Ugbede Oyibo and Ismaila Arzika Mungadi},
      title = {Management of Impacted Urethral Calculi: An Uncommon Cause of Acute Urine Retention in North-western Nigeria},
      journal = {International Journal of Clinical Urology},
      volume = {4},
      number = {1},
      pages = {1-5},
      doi = {10.11648/j.ijcu.20200401.11},
      url = {https://doi.org/10.11648/j.ijcu.20200401.11},
      eprint = {https://download.sciencepg.com/pdf/10.11648.j.ijcu.20200401.11},
      abstract = {Urethral stones though rare manifestation of urolithiasis may be primary but mostly are secondary arising from either the urinary bladder or the upper tract. When impacted in the urethra may result in acute urinary retention and difficulty in urethral catheterization. Various treatment modalities are available ranging from initial suprapubic cystostomy and subsequent open surgical or endoscopic procedures as well as treatment of associated urethral pathology. We report our experience in the management of patients with acute urine retention due to impacted urethral calculi in a tertiary hospital. This was a retrospective review of forty patients with impacted urethral stones managed at the Urology Unit, Department of Surgery Usmanu Danfodiyo University Teaching Hospital Sokoto from January 2005 to December 2015. Data were collected from patients’ case notes and entered in to a proforma and analysed using SPSS 20.0 version for Windows. Forty patients comprising of one female (2.5%) and 39 males (97.5%), mean age was 25±17.4 years with a range of 1-63yrs. In twenty patients (50%), attempt at urethral catheterization was not successful. Location of the impacted calculi were meatal 7 (17.5%), distal penile 4 (10%), mid penile 8 (20%), proximal penile 1 (2.5%), bulbar 4 (10%), peno-bulbar junction 3 (7.5%), posterior urethra 11 (27.5%), and bladder neck 2 (5%). Spontaneous extrusion of the calculi occurred in 4 (10%), while expulsion occurred in 2 (5%) after intra-urethral instillation of 2% lidocaine jelly. Other treatment modalities in the remaining patients included; meatotomy 11 (27.5%), open urethrolithotomy 6 (15%), urethroscopy and pneumatic lithotripsy 6 (15%), urethroscopy and stone retrieval 1 (2.5%), urethrolithotomy and urethroplasty 2 (5%), and cystolithotomy 8 (20%). Impacted urethral stone may be a cause of acute urinary retention and failed urethral catheterisation. The stone can pass spontaneously with or without manipulation or can be removed by endoscopic or open technique when spontaneous passage is not successful.},
     year = {2020}
    }
    

    Copy | Download

  • TY  - JOUR
    T1  - Management of Impacted Urethral Calculi: An Uncommon Cause of Acute Urine Retention in North-western Nigeria
    AU  - Ngwobia Peter Agwu
    AU  - Abdullahi Abdulwahab-Ahmed
    AU  - Abubakar Muhammadu Sadiq
    AU  - Emmanuel Ugbede Oyibo
    AU  - Ismaila Arzika Mungadi
    Y1  - 2020/01/07
    PY  - 2020
    N1  - https://doi.org/10.11648/j.ijcu.20200401.11
    DO  - 10.11648/j.ijcu.20200401.11
    T2  - International Journal of Clinical Urology
    JF  - International Journal of Clinical Urology
    JO  - International Journal of Clinical Urology
    SP  - 1
    EP  - 5
    PB  - Science Publishing Group
    SN  - 2640-1355
    UR  - https://doi.org/10.11648/j.ijcu.20200401.11
    AB  - Urethral stones though rare manifestation of urolithiasis may be primary but mostly are secondary arising from either the urinary bladder or the upper tract. When impacted in the urethra may result in acute urinary retention and difficulty in urethral catheterization. Various treatment modalities are available ranging from initial suprapubic cystostomy and subsequent open surgical or endoscopic procedures as well as treatment of associated urethral pathology. We report our experience in the management of patients with acute urine retention due to impacted urethral calculi in a tertiary hospital. This was a retrospective review of forty patients with impacted urethral stones managed at the Urology Unit, Department of Surgery Usmanu Danfodiyo University Teaching Hospital Sokoto from January 2005 to December 2015. Data were collected from patients’ case notes and entered in to a proforma and analysed using SPSS 20.0 version for Windows. Forty patients comprising of one female (2.5%) and 39 males (97.5%), mean age was 25±17.4 years with a range of 1-63yrs. In twenty patients (50%), attempt at urethral catheterization was not successful. Location of the impacted calculi were meatal 7 (17.5%), distal penile 4 (10%), mid penile 8 (20%), proximal penile 1 (2.5%), bulbar 4 (10%), peno-bulbar junction 3 (7.5%), posterior urethra 11 (27.5%), and bladder neck 2 (5%). Spontaneous extrusion of the calculi occurred in 4 (10%), while expulsion occurred in 2 (5%) after intra-urethral instillation of 2% lidocaine jelly. Other treatment modalities in the remaining patients included; meatotomy 11 (27.5%), open urethrolithotomy 6 (15%), urethroscopy and pneumatic lithotripsy 6 (15%), urethroscopy and stone retrieval 1 (2.5%), urethrolithotomy and urethroplasty 2 (5%), and cystolithotomy 8 (20%). Impacted urethral stone may be a cause of acute urinary retention and failed urethral catheterisation. The stone can pass spontaneously with or without manipulation or can be removed by endoscopic or open technique when spontaneous passage is not successful.
    VL  - 4
    IS  - 1
    ER  - 

    Copy | Download

  • Sections