Pediatric acute urinary retention due to impacted urethral meatal calculus: a rare case report

Abstract

Urethral calculus is rare in pediatrics, especially with acute urinary retention. The diagnosis of urethral calculus is made by proper history taking, physical examination, and imaging studies. In this case, the diagnosis was made mainly by anamnesis, inspection, and palpation of the calculus in the external urethral meatus. Invasive and less invasive procedures such as open surgery, meatotomy, or laser lithotripsy procedure, can be a management of urethral calculus. In this case, simple extraction was performed without meatotomy or other invasive procedures. A 5-year-old, boy was reported to come to the emergency department because of severe pain in his penis and acute urinary retention.  The patient had a history of dysuria, a habit of delaying urination, and low fluid intake. On physical examination, it was found a distention in the suprapubic area and a green-white solid mass at the external urethral meatus. A 10-millimeter calculus was successfully extracted from the external urethral meatus with simple extraction procedures under local anesthesia. This case report demonstrated a rare case of pediatric acute urinary retention secondary to impacted urethral meatal calculus in an emergency setting of a low-level hospital.  Immediate and proper management was required due to the patient's condition and considering the lack of facilities. The extraction of calculus with minimal urethral damage was the recommendation.