A urethral stone as the cause of acute urinary retention in a pediatric patient
DOI:
https://doi.org/10.48193/revistamexicanadeurologa.v79i2.481Keywords:
Urethra, Stone, Lithiasis, Urinary tractAbstract
Background. Acute urinary retention is a common urologic emergency. It rarely presents in children, in whom it has been associated with a wide variety of causes, such as mechanical obstruction (stones or strictures), constipation, infection and inflammation, fecal impaction, neurologic and gynecologic diseases, malignancy, or behavioral or idiopathic etiology, among others.
Clinical case: A 2-year-old boy, with no family history of kidney stones, presented with sudden abdominal pain accompanied by crying during micturition. Cystostomy was performed in the emergency room and the patient was referred to the specialist at our hospital center for evaluation. Physical examination revealed a foreign body in the urethra. Urethrocystoscopy was immediately carried out with a pediatric urethrocystoscope, and a stone in the anterior urethra was found.
Discussion. Urinary stones in children are an uncommon pathology and are rarely a cause of acute urinary retention (2%). It is more common in boys and in the anterior urethra. Pediatric patients with posterior urethral stones have continuous urine dripping and those with anterior urethral stones present with acute urinary retention. The use of endoscopic equipment is safe for resolving urethral stones and should be considered the first treatment option, when available.
References
2. Traslaviña GAA, Ciampo LAD, Ferraz IS. Acute urinary retention in a pre-school girl with constipation. Rev Paul Pediatr. 2015;33(4):488–92. [accessed 28 May 2019] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4685571/
3. Arena F, Fede C, Romeo C, Racchiusa S, Scalfari G, Zimbaro G, et al. [Acute urine retention: early clinical sign of a rhabdomyosarcoma of the bladder or prostate in children: report of three cases]. Pediatr Medica E Chir Med Surg Pediatr. 2003;25(2):139–44.
4. Shih S-L, Liu Y-P, Tsai J-D, Tsai Y-S, Yang F-S, Chen Y-F. Acute urinary retention in a 7-year-old girl: an unusual complication of cytomegalovirus cystitis. J Pediatr Surg. 2008;43(11):e37-39. doi: https://doi.org/10.1016/j.jpedsurg.2008.07.015
5. Gatti JM, Perez-Brayfield M, Kirsch AJ, Smith EA, Massad HC, Broecker BH. Acute urinary retention in children. J Urol. 2001;165(3):918–21.
6. Sharma AP, Filler G. Epidemiology of pediatric urolithiasis. Indian J Urol IJU J Urol Soc India. 2010;26(4):516–22. [accessed 28 May 2019] Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3034060/
7. Ameen AA, Kegham HH, Abid AH. Evaluation and management of urethral calculi. Int Surg J. 2017;4(8):2392–6. [accessed 28 May 2019] Available from: https://www.ijsurgery.com/index.php/isj/article/view/1593
8. Scales CD, Curtis LH, Norris RD, Springhart WP, Sur RL, Schulman KA, et al. Changing gender prevalence of stone disease. J Urol. 2007;177(3):979–82. doi: https://doi.org/10.1016/j.juro.2006.10.069
9. Novak Thomas E, Trock Bruce J, Lakshmanan Yegappan, Gearhart John P, Matlaga Brian R. Gender distribution among pediatric stone formers. J Urol. 2009;181(4S):380–1. [accessed 28 May 2019] Available from: https://www.auajournals.org/doi/10.1016/S0022-5347%2809%2961076-4
10. Asgari SA, Mansour Ghanaie M, Simforoosh N, Kajbafzadeh A, Zare’ A. Acute urinary retention in children. Urol J. 2005;2(1):23–7.
11. Nevo A, Mano R, Livne PM, Sivan B, Ben-Meir D. Urinary Retention in Children. Urology. 2014;84(6):1475–9. [accessed 28 May 2019] Available from: https://www.goldjournal.net/article/S0090-4295(14)00946-7/abstract
12. Bedii Salman A. Urethral calculi in children. J Pediatr Surg. 1996;31(10):1379–82.
13. Akhtar J, Ahmed S, Zamir N. Management of impacted urethral stones in children. J Coll Physicians Surg--Pak JCPSP. 2012;22(8):510–3. doi: 08.2012/JCPSP.510513
14. Vaddi SP, Devraj R, Reddy V, Vikram A, Dayapule S, Munisami R. Urethral steinstrasse causing acute urinary retention. Urology. 2011;77(3):594–5. doi: https://doi.org/10.1016/j.urology.2010.04.003
15. González Herrero M, Morante Valverde R, Tordable Ojeda C, Cabezali Barbancho D, López Vázquez F, Gómez Fraile A. [Therapeutic approach in urinary tract stones in children]. Cirugia Pediatr Organo Of Soc Espanola Cirugia Pediatr. 2014;27(3):135–9.
16. Orozco Fariñas R, Iglesias Prieto JI, Pellejero Pérez P, Massarrah Halabi J, Mancebo JM, Pérez-Castro Ellendt E. [Treatment of pediatric lithiasis in the lithotripsy and endourology unit of ‘Hospital La Luz’. Commented retrospective of our case series]. Arch Esp Urol. 2016;69(7):405–15.
