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Urethral calculi are an uncommon type of urolithiasis, accounting for ~1% of all urinary tract stones.
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They almost all occur in males 2 with two peak incidences - one in childhood and the other at 40 years 3.
Most commonly acute lower urinary tract symptoms and/or urinary retention.
Urethral calculi are most commonly calcium oxalate (~85%) and can be either 1,2,5:
- primary: arising de novo secondary to other pathologies such as diverticula, strictures, neurogenic bladder or foreign bodies
- secondary: originate in the upper urinary tract (much more common)
Most impact in the prostatic urethra although ~40% (range 30-50%) are found in the anterior urethra 2,5.
Almost all (98-100%) of urethral stones are reported to be radiopaque 3 but most are small and only faintly radiopaque and up to 60% will be missed 5.
- pelvic phlebolith
- prostatic calcification: transrectal ultrasound can be helpful for differentiation 4
- Coaptite injection 6
- 1. Gonzalez C. BJUI. 2012; . doi:10.1002/BJUIw-2012-068-web
- 2. Bielawska H, Epstein NL. A stone down below: a urethral stone causing acute urinary retention and renal failure. CJEM. 2010;12 (4): 377-80. Pubmed citation
- 3. Wein AJ, Kavoussi LR, Novick AC et-al. Campbell-Walsh Urology (Campbell's Urology (4 Vols.)). Saunders. ISBN:B0069S9RB0. Read it at Google Books - Find it at Amazon
- 4. Genitourinary Radiology: Kidney, Bladder and Urethra: The Pathologic Basis. Springer. ISBN:1848002440. Read it at Google Books - Find it at Amazon
- 5. Lower Genitourinary Radiology: Imaging and Intervention. Springer. ISBN:1461272300. Read it at Google Books - Find it at Amazon
- 6. Hosseinzadeh K, Heller MT, Houshmand G. Imaging of the female perineum in adults. Radiographics. 2012;32 (4): E129-68. doi:10.1148/rg.324115134 - Pubmed citation