Pediatric acute urinary retention due to impacted urethral meatal calculus: a rare case report

Authors

  • Arief Fadli Putra Department of Emergency Medicine, Hospital of Bima, West Nusa Tenggara, Indonesia
  • Fajar Awalia Yulianto Department of Public Health, Bandung Islamic University, West Java, Indonesia https://orcid.org/0000-0003-3682-5744

DOI:

https://doi.org/10.18203/2349-2902.isj20240670

Keywords:

Urinary retention, Pediatric, Urethral calculus, External urethral meatus

Abstract

Urethral calculus is rare in pediatrics, especially with acute urinary retention. The diagnosis of urethral calculus is made by proper history taking, physical examination, and imaging studies. In this case, the diagnosis was made mainly by anamnesis, inspection, and palpation of the calculus in the external urethral meatus. Invasive and less invasive procedures such as open surgery, meatotomy, or laser lithotripsy procedure, can be a management of urethral calculus. In this case, simple extraction was performed without meatotomy or other invasive procedures. A 5-year-old, boy was reported to come to the emergency department because of severe pain in his penis and acute urinary retention.  The patient had a history of dysuria, a habit of delaying urination, and low fluid intake. On physical examination, it was found a distention in the suprapubic area and a green-white solid mass at the external urethral meatus. A 10-millimeter calculus was successfully extracted from the external urethral meatus with simple extraction procedures under local anesthesia. This case report demonstrated a rare case of pediatric acute urinary retention secondary to impacted urethral meatal calculus in an emergency setting of a low-level hospital.  Immediate and proper management was required due to the patient's condition and considering the lack of facilities. The extraction of calculus with minimal urethral damage was the recommendation.

References

Jobs K, Rakowska M, Paturej A. Urolithiasis in The Pediatric Population-Current Opinion on Epidemiology, Pathophysiology, Diagnostic Evaluation and Treatment. Dev Period Med. 2018;22(2):201-8.

Stacia M, Mastika N, Wulandari N, Santosa K. Pediatric Urolithiasis Presenting as Acute Urinary Retention: a case report and review. Int J Med Rev Case Rep. 2019;3(12):901-4.

Mbouché LO, Andzé GO, Makon ASN, Nyanit BD, Tamufor EN, Amenglé AL, et al. Acute Urinary Retention in the Male Child from Urethral Calculi: A Report of Three Cases. Case Rep Urol. 2019;2019:1-7.

Kahle PJ, Mellinger GT. Urethral calculi. Urol Cutaneous Rev.1949;53(11):674-7.

Ali MW, Azmi YA, Santoso AD, Soebadi DM. Giant long-standing urethral calculus without urinary retention: A case report. Int J Surg Case Rep. 2023;106:108084.

Hussain Phul A, Fatima S, Unar F, Muhammad K, Ali Shaikh M. Management of Obstructive Uretheral Stone Patients. 2014.

Sungur M, Baykam M, Calışkan S, Lokman U. Urethral calculi: A rare cause of acute urinary retention in women. Turk J Emerg Med. 2018;18(4):170-1.

Balarabe HS, Jeannot BM, Kibansha HM, Isaac E, Kiswezi A. Urethral calculus with a recurrent acute urinary retention in a male child aged 11 years: A case report. Radiol Case Rep. 2023;18(11):4191-4.

Hoffmann KS, Godse A. Impacted urethral stone presenting as urinary retention in a child. BMJ Case Rep. 2021;14(1).

Rizvi SAH, Naqvi SAA, Hussain Z, Hashmi A, Hussain M, Zafar MN, et al. Pediatric Urolithiasis: Developing Nation Perspectives. J Urol. 2002;168(4-1):1522-5.

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Published

2024-03-08

Issue

Section

Case Reports