Two giant stones located in the penile and prostatic urethra: a case report and review of the literature

Urethral stones account for less than 2% of all urinary stone diseases in developed countries. Most urethral stones are associated with abnormalities that predispose individuals to urinary stasis and infections, such as strictures, lower urinary tract surgery, congenital or acquired diverticula, chronic urinary infections, foreign bodies, and schistosomiasis. The aim of this case report was to present a fifty-nine-year-old man with two giant penile and prostatic ureteral stones who received a different treatment approach. After the impacted urethral stone was seen in the anterior urethra in ureteroscopy, urethrotomy was performed with a 3 cm vertical incision in the penile urethra. Pneumatic lithotripsy was performed extracorporeally via incision. The stone in the penile urethra was disintegrated and extracted using forceps. The prostatic stone was pushed back into the bladder and disintegrated by the same urethral incision with a lithotripter through a cystourethroscope. For large, impacted urethral stones, external urethrotomy combined with externally pneumatic lithotripsy may prevent long urethral incisions. Therefore, this technique may reduce the risk of postoperative stricture.