Diagnostic challenges in urethral calculi; an initial tertiary care study

Background. Kidney stone disease possesses a significant health burden not only to the family but also to the society. Sometimes, urethral stones are not expressed by typical manifestations, which can mislead clinicians in making the diagnosis. Materials and Methods. The investigation covers a period of 1 year and 6 months (Oct. 2020-Jan. 2022), carried out after obtaining the written informed consent of 22 symptomatic patients. KUB and pelvis X-ray (with or without perineal ultrasound) were performed after ethical clearance in a single center tertiary care hospital. Results. This study reveals male preponderance with no female patients, mostly in the age groups of 35-50 years (all being symptomatic). 54.54% have retention of urine and 45.45% with features of voiding lower urinary tract symptoms (LUTS); in 20% of cases, additional perineal ultrasound was performed to confirm the diagnosis. It is found that 63.63% of the stones were in the anterior part and 36.36% of the stones are in the posterior part of the urethra, 4.5% of the stones being radiolucent. Two patients were treated by meatotomy and 20 patients were treated by retrograde manipulation and fragmentation of stone by pneumatic lithoclast. Conclusions. In an extremely clinically suspicious case, an effective investigation, such as an X-ray of the pelvis and pelvis and/ or perineal ultrasound, can be used as the best diagnostic tools for urethral stones.