External Urethral Meatus Stone in Women with Urinary Retention: A Rare Case Report
Main Article Content
Ureteral stones are commonly found in the kidneys, ureters, and bladder, whereas urethral stones are rare, accounting for less than 1% of all urinary tract stone cases. The prevalence is approximately 7 cases per 100,000 individuals, with a significantly higher occurrence in men, at a male-to-female ratio of 13:1. This research aims to report a rare case of urethral stone in a female patient and evaluate the effectiveness of manual stone extraction with local anesthesia as a minimally invasive treatment option. This research employs a case research approach by analyzing the clinical presentation, diagnostic findings, and treatment outcomes of a 55-year-old woman who presented at the emergency department with acute urinary retention lasting two hours, accompanied by genital pain. Physical examination revealed no abnormalities in the abdomen, but a stone was identified at the external urethral meatus. The patient underwent manual stone extraction under 2% lidocaine local anesthesia using nalfuder. The procedure involved fragmenting the stone into smaller pieces before complete removal, successfully restoring normal urination. The findings emphasize the rarity of urethral stones in female patients and highlight acute urinary retention as a key clinical manifestation. The successful outcome of manual extraction with local anesthesia demonstrates its efficacy as a minimally invasive approach, offering valuable insights for improving the management of urethral stones. This research contributes to the medical literature by supporting manual extraction as an effective and less invasive alternative in appropriate cases.
Al Lawati, H., Blair, B. M., & Larnard, J. (2024). Urinary Tract Infections: Core Curriculum 2024. American Journal of Kidney Diseases, 83(1), 90–100. https://doi.org/10.1053/j.ajkd.2023.08.009
Chiu, H. H. C., & Sandoval, M. A. S. (2020). Resistant hypertension after shockwave lithotripsy: the rude awakening of an adrenal incidentaloma. BMJ Case Reports CP, 13(8), e235261.
Dombeck, C., Scales, C. D., McKenna, K., Swezey, T., Harper, J. D., Antonelli, J. A., Desai, A. C., Lai, H. H., McCune, R., Curatolo, M., Al-Khalidi, H. R., Maalouf, N. M., Reese, P. P., Wessells, H., Kirkali, Z., & Corneli, A. (2023). Patients’ Experiences With the Removal of a Ureteral Stent: Insights From In-depth Interviews With Participants in the USDRN STENTS Qualitative Cohort Research. Urology, 178, 26–36. https://doi.org/10.1016/j.urology.2023.04.018
Gottlieb, M., Long, B., & Koyfman, A. (2018). The evaluation and management of urolithiasis in the ED: A review of the literature. The American Journal of Emergency Medicine, 36(4), 699–706. https://doi.org/10.1016/j.ajem.2018.01.003
Hamza, B. K., Bello, A., Tolani, M. A., Makama, J. G., & Yusuf, N. (2021). An impacted urethral stone: a rare cause of acute urinary retention in women—case report. African Journal of Urology, 27(1), 138. https://doi.org/10.1186/s12301-021-00225-y
Lee, P., & Haber, J. (2020). Urethral Calculi. Clinical Practice and Cases in Emergency Medicine, 4(2), 134–136. https://doi.org/10.5811/cpcem.2019.5.43182
Morgan, K., Rees, C. D., Shahait, M., Craighead, C., Connelly, Z. M., Ahmed, M. E., & Khater, N. (2022). Urolithiasis in pregnancy: Advances in imaging modalities and evaluation of current trends in endourological approaches. Actas Urológicas Españolas (English Edition), 46(5), 259–267. https://doi.org/10.1016/j.acuroe.2022.03.005
Morton, A., Tariq, A., Dunglison, N., Esler, R., & Roberts, M. J. (2024). Etiology and management of urethral calculi: A systematic review of contemporary series. Asian Journal of Urology, 11(1), 10–18. https://doi.org/10.1016/j.ajur.2021.12.011
Panicker, J. N., Fowler, C. J., & Kessler, T. M. (2015). Lower urinary tract dysfunction in the neurological patient: clinical assessment and management. The Lancet Neurology, 14(7), 720–732.
Purnama, D. K., & Santoyo, W. H. (2022). Posterior Lubrication in a patient Urinary retention ec suspect urethral stones. Jurnal Llmu Bedah Indonesia, 50(1).
Sungur, M., Baykam, M., Cal??kan, S., & Lokman, U. (2018). Urethral calculi: A rare cause of acute urinary retention in women. Turkish Journal of Emergency Medicine, 18(4), 170–171. https://doi.org/10.1016/j.tjem.2018.02.002
Thomas, L. D., & Henn, M. C. (2021). Perfecting the Gastrointestinal Physical Exam: Findings and Their Utility and Examination Pearls. Emergency Medicine Clinics, 39(4), 689–702.
Türk, C., Pet?ík, A., Sarica, K., Seitz, C., Skolarikos, A., Straub, M., & Knoll, T. (2016). EAU Guidelines on Diagnosis and Conservative Management of Urolithiasis. European Urology, 69(3), 468–474. https://doi.org/10.1016/j.eururo.2015.07.040
Wessells, H., Angermeier, K. W., Elliott, S., Gonzalez, C. M., Kodama, R., Peterson, A. C., Reston, J., Rourke, K., Stoffel, J. T., & Vanni, A. J. (2017). Male urethral stricture: American urological association guideline. The Journal of Urology, 197(1), 182–190.
