Acute Urinary Retention in the Male Child from Urethral Calculi: A Report of Three Cases

Abstract

Urinary stones are uncommon in children. Urethral location of calculi can give rise to various clinical manifestations. We report three cases of urethral lithiasis presenting with acute urinary retention in children.

Urethral Stone: A Rare Cause of Acute Retention of Urine in Men

“…The clinical symptomatology is very variable ranging from simple penile pain with dysuria to complete urinary retention [6], these untreated or ignored stones may lead to serious complications such as the formation of an abscess and necrosis, urinary fistula or even penile gangrene [2] [6].…”

“…The diagnosis is most often easy by interrogation which seeks the history of urinary stones disease or emission of calculus, penile pain, and by the clinical examination which made it possible to palpate a mobile hard urethral mass when it is not impacted and located at the anterior urethra [6]. In other cases, the diagnosis can be confirmed by a simple radiography centered on the external genitalia or a penile ultrasound in the case of radiolucent stones which are not rare [7].…”

“…The treatment remains poorly codified, they depend on the size, the number, the localization of the calculus as well as the presence or not of an underlying urethral pathology and the existence or not of a complication modifying the surgical approach [1] [7]. Minimally invasive endoscopic approach by urethroscopy is to be preferred for small proximal calculi with the possibility of extracting them or fragments in situ or pushing them back into the bladder and fragmenting them by laser or lithotripsy with success rates close to 80% [1] [6] [7]. For a large, multiple, distal stones and stones encrusted in the urethra, conventional open surgery with a meatotomy or sometimes an urethrotomy with or without urethroplasty is an excellent therapeutic means [2] [7].…”

“…Regarding open surgical treatment, Mbouché [6] reported the case of three patients with obstructive and impacted urethral calculi successfully treated by an open urethrolithotomy. Agwu [7] also reported in a series of 39 patients the different surgical treatment methods depending on the location and size of the stones, as well as the existence or not of an underlying urethral pathology, a meatotomy was performed in 11 (27.5%) patients, an open urethrolithotomy in 6 (15%) patients, urethrolithotomy and urethroplasty in 2 (5%) patients, this series highlights the essential place that occupies open surgical treatment in the management of distal and impacted urethral calculi.…”

A rare presentation of urolithiasis in a child with urine retention from a nonendemic area: a case report and literature review

“…Even though urinary tract stones are a relatively common problem, urethral stones are a rare type of urolithiasis, accounting for ~1% of all presentations 1 . Penile urethral stones are much rarer, with an incidence of less than 0.3% 1 , and even so, 20 times rarer in children 2 . The presence of an obstructing urethral stone causing acute urine retention is a urology emergency requiring immediate intervention 3 .…”