ABSTRACT
OBJECTIVE: To determine the occurrence, symptoms, treatment and outcome in patients with urethral stones. PATIENTS AND METHODS: Fifty-one consecutive patients with urethral calculi were assessed prospectively; all were male and one was an infant. RESULTS: Acute retention of urine occurred in 78% of patients, urethral anatomical pathology in 6% and posterior urethral calculi in 88%. The urethral stones, solitary in each patient, consisted of calcium oxalate in 86%, struvite in 6%, mixed stones in 4%, calcium phosphate in 2% and uric acid in 2%. A methodical approach to therapy was used which aimed to clearly define the circumstances in which a given procedure was used, and the resulting success rate. CONCLUSION: The common belief that most urethral calculi in patients in developing countries originate from the bladder does not seem to be generally applicable. Urethral anatomical pathology does not seem to be a necessary condition for most of these calculi.
Subject(s)
Urethral Diseases/therapy , Urinary Calculi/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Child , Humans , Lithotripsy/methods , Male , Middle Aged , Prospective Studies , Treatment Outcome , Urethral Diseases/diagnosis , Urethral Diseases/ethnology , Urinary Calculi/diagnosis , Urinary Calculi/ethnology , Urinary Retention/etiology , Urinary Retention/therapyABSTRACT
In an 8-year old negroid girl vaginal bleeding was caused by urethral prolapse.
Subject(s)
Urethral Diseases/diagnosis , Black People , Child , Child Abuse, Sexual/diagnosis , Diagnosis, Differential , Female , Humans , Prolapse , Urethral Diseases/ethnology , Urethral Diseases/pathology , Vaginal Diseases/diagnosisABSTRACT
We report our experience with 23 girls with urethral prolapse. Vaginal bleeding was the most common complaint, and predisposing factors (cough, trauma, and constipation) were found in 10 children. Although reported almost exclusively in black girls, 14 of the 23 patients were white. Three basic techniques were used for therapy: conservative management, ligation over a Foley catheter, and total excision of the prolapse. Ligation over a Foley catheter had a high incidence of complications (partial recurrence, infection, postoperative pain) and is no longer used. The best results were obtained by complete excision of the urethral prolapse. We propose that treatment should be based on the etiopathogenesis of the prolapse and the clinical condition of the child; patients with a single and acute episode of increased abdominal pressure, such as trauma, and those at high risk for general anesthesia are managed by conservative therapy. All others, and patients who fail medical treatment, undergo surgical excision.
