Urolithiasis is the third-most common disease of the urinary tract, exceeded only by urinary tract infections and pathologic conditions of the prostate [1]. Urinary tract calculi commonly affect the kidney, ureter and bladder. Urethral calculi are rare, representing 1–2% of all calculi affecting the urinary tract [2]. Urethral calculi are extremely rare in females [3]. This is probably as a result of a shorter urethra, which has a straight course. The male urethra is much longer and makes almost a 90-degree curvature at the bulbar urethra. This angulation may contribute to the increased predisposition of males to urethral calculi. In addition, there is luminal size disparity in the male urethra, the penile being of smaller diameter as compared to the bulbar urethra.
Urethral calculi can be classified as primary and secondary or migratory urethral calculi [4]. Majority of urethral calculi are secondary, their primary site is usually the bladder or upper urinary tract [5]. Primary or de novo urethral calculi result from condensation of stone materials on foreign body or around the areas of stasis such as urethral diverticulum.
A literature review of impacted urethral calculi in women revealed isolated case reports. In one of the largest series on impacted urethral stone, a retrospective 10 year period at the Usman Danfodio University Teaching Hospital, Sokoto, in North- western Nigeria, only one female (2.5%) was seen out of a total of forty patients [6].
We present a 35-year-old woman with acute urinary retention secondary to an impacted urethral stone. Our treatment approach is relevant to many centers in developing countries. Amole et al. reported on successful extraction of an impacted female urethral stone via the external meatus after copious lubrication [7]. This line of treatment was not successful in this patient due to the size of the stone.
We aim to describe successful management of an impacted urethral stone in a woman, who presented to a low resource center that lacks the modern facilities for the treatment of urolithiasis.