A Giant Dumbbell Shaped Vesico-Prostatic Urethral Calculus: A Case Report and Review of Literature

Abstract

Calculi in the urethra are an uncommon entity. Giant calculi in prostatic urethra are extremely rare. The decision about treatment strategy of calculi depends upon the size, shape, and position of the calculus and the status of the urethra. If the stone is large and immovable, it may be extracted via the perineal or the suprapubic approach. In most of the previous reported cases, giant calculi were extracted via the transvesical approach and external urethrotomy. A 38-year-old male patient presented with complaints of lower urinary tract symptoms. Further investigations showed a giant urethral calculus secondary to stricture of bulbo-membranous part of the urethra. Surgical removal of calculus was done via transvesical approach. Two calculi were found and extracted. One was a huge dumbbell calculus and the other was a smaller round calculus. This case was reported because of the rare size and the dumbbell nature of the stone. Giant urethral calculi are better managed by open surgery.

Anastomotic Urethroplasty for an Obstructing Calculus Within a Bulbar Urethral Diverticulum and Urethral Stricture

“…Calculi in the posterior urethra may be relocated retrograde into the bladder and treated using minimally invasive or open techniques. Open transvesical prostatolithotomy has been reported for a large vesico-prostatic calculus 2 . Small calculi in the anterior urethra may be ‘milked’ out of the urethra and extracted.…”

Neurogenic Bladder Complicated with Giant Urethral Stone in a Male

“…They are usually encountered in males. Primary urethral stones are generally small, multiple and formed de novo in the urethra; secondary urethral stones are usually larger and formed in the upper urinary tract with secondary downward descent [1]. Primary urethral calculi are usually associated with urethral stricture, posterior urethral valve disorder, diverticula, neurogenic bladder, and foreign body [2].…”

“…Urethral calculi most usually originate from the upper urinary tract or from the bladder, but also it can form in situ. When stones occlude the urethra, it can cause acute urinary retention, urethral injury and obstructive renal failure [1][2][3]. To date, diagnosing urethral calculi is still challenging due to nonspecific symptoms.…”

“…To date, diagnosing urethral calculi is still challenging due to nonspecific symptoms. Giant urethral stones can lead to long-term urethral damage, incontinence and renal insufficiency [1][2][3].…”

“…Giant urethral calculus is uncommon and can cause acute renal failure associated with urological tract outflow obstruction combined with urinary tract infection and sepsis [1][2][3]. Patients who …”