RESULTSAcute retention of urine occurred in 78% of patients, urethral anatomical pathology in 6% and posterior urethral calculi in 88%. The urethral stones, solitary in each patient, consisted of calcium oxalate in 86%, struvite in 6%, mixed stones in 4%, calcium phosphate in 2% and uric acid in 2%. A methodical approach to therapy was used which aimed to clearly define the circumstances in which a given procedure was used, and the resulting success rate. CONCLUSIONThe common belief that most urethral calculi in patients in developing countries originate from the bladder does not seem to be generally applicable. Urethral anatomical pathology does not seem to be a necessary condition for most of these calculi.

patent anastomosis and 6 (60%) of these were dry following implantation of an AUS. 1 other patient had 4 consecutive sphincter implants all of which eroded. 1 patient developed a re-stenosis and was managed thereafter by suprapubic catheterisation. Two had incomplete healing of their anastomosis and developed a urosymphyseal fistula and unfortunately were subsequently worse off as a result of their surgery.CONCLUSIONS: Patients with a recalcitrant BNC after RP with no history of radiotherapy can be treated as with any other traumatic urethral stenosis e in this instance iatrogenic trauma by revision of the vesico-urethral anastomosis. The results are very satisfactory. With careful selection some patients who have had radiotherapy can be treated in the same way but there should be careful evaluation of the state of the pubis and pubic symphysis preoperatively as well as careful urodynamic evaluation of the bladder function, to avoid the very poor outcome in patients who fail such surgery. All patients must be counseled that this will almost certainly be a two-stage reconstruction -the first to dis-obstruct them by revision of the VUA and then secondly to implant an AUS for the almost (but not necessarily) inevitable sphincter weakness incontinence following dis-obstruction.