Urethral stone

Case contributed by Fakhry Mahmoud Ebouda
Diagnosis almost certain


Acute urine retention for investigation.

Patient Data

Age: 40 years.
Gender: Male

An oblong radioopaque shadow is seen partially overlying the symphysis pubis.


An oblong hyperdense stone measuring about 18 x 10 mm in maximum dimensions. It measures (891 HFU) in density. It is noted lower down and impacted within the posterior prostatic urethra just inferior to the urinary bladder neck. Multiple tiny small, hyperdense foci noted within the lower and middle calyx of the right kidney, with the largest is lower calyceal measuring about 3 mm in maximum diameter suggestive of multiple right renal gravels. The left kidney is relatively smaller in size with relative thinning out of the renal parenchyma. It has lobulated irregular cortical margins. Mild to moderate prominent left renal collecting calyceal system, left renal pelvis as well as left ureter downstream to the level of the left vesicoureteric junction. Minimal perinephric fat strandings. Images could be suggestive of chronic pyelonephritis changes with other changes post to recently passed stone. 

Case Discussion

An oblong stone was impacted within the posterior urethra. It was extracted via intervention urethroscopy. The presentation of the patient was acute that gave no enough time for developing upstream backpressure changes. 

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