Urethral obstruction from dislodged bladder Diverticulum stones: a case report

A 69 year old, male, Nigerian with clinical and radiological features of acute urinary retention, benign prostate enlargement and bladder diverticulum. He had a transurethral resection of the prostate (TURP) and was lost to follow up. He re-presented with retained urethral catheter of 4months duration. The catheter was removed but attempt at re-passing the catheter failed and a suprapubic cystostomy was performed. Clinical examination and plain radiograph of the penis confirmed anterior and posterior urethral stones. He had meatotomy and antegrade manual stone extraction with no urethra injury.Urethral obstruction can result from inadequate treatment of patient with benign prostate enlargement and bladder diverticulum stones. Surgeons in resource limited environment should be conversant with transurethral resection of the prostate and cystolithotripsy or open prostatectomy and diverticulectomy.The incidence of urolithiasis has increased in Germany, but the situation is variable in the United States [1]. The northern part of Nigeria has a higher incidence of stone disease and the majorities are located in the upper urinary tract [2]. However, the urinary tracts stone distribution in Lagos was renal stones 22.2%, ureteric 35.5%, and vesical was 35.5%. While urethral stones constituted 2.2% [3] and this percentage of urethral stone is similar to reports from the developed countries [4]. Urethral stone frequently originated from the upper urinary tract or the urinary bladder [5] and was commonly found in either the anterior or posterior urethra where it often presented with acute urinary retention. Primary urethral stones are rare, but secondary stones are seen in patient with urethral stricture [6]. We present urethral obstruction from dislodged bladder diverticulum stones and its management in a resource limited environment. This to our knowledge is the first case in Nigeria and in English literature search.A 69 year old, male, Nigerian who was initially seen with a 4