PMC6537023_01
Palpation of mass at the base of the penis (case 1).
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fig1
A tense and sensitive bladder was palpated in the suprapubic region as well as a hard mass, at the base of the penis (Figure 1).
Plain abdominal radiograph showing the urethral calculus (case 1).
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fig2
An abdominal scout film showed a rounded opacification beneath the pubic symphysis (Figure 2).
VCUG (elongated, dilated urethra) (case 1).
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fig3
Voiding radiographs confirmed interruption to flow in the penile urethra with proximal urethral dilatation (Figure 3).
Postvoid residue on VCUG (case 1).
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fig4
The postvoid residual volume was significant (Figure 4).
Endoscopic view of the calculus (case 1).
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fig5
At urethroscopy, a stone completely obstructing the lumen and encrusted in the urethral wall, prevented endoscopic extraction (Figure 5).
Extracted urethral stone (case 1).
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fig6
An elongated 6 mm x 9 mm lithiasis with a crystalline surface was extracted (Figure 6).
PMC6537023_02
(a) Suprapubic bladder distension (case 2); (b) meatal stenosis (case 2).
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fig7
Physical examination revealed an agitated child, writhing with pain in the hypogastric region, and a palpable full bladder (Figure 7).
Suprapubic cystostomy in place (case 2).
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fig8
Palpation of the body of the penis did not reveal any masses. 600 ml of clear urine was drained from an urgent bedside 8 Fr cystostomy (Figure 8).
(a) Scout film, stone in the penile midshaft (case 2). (b) VCUG, partial urethral obstruction (case 2).
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fig9
A scout film confirmed an ovoid calculus in the proximal part of the anterior urethra (Figure 9).
(a) Urethral calculus, in situ (case 2). (b) Extracted calculus (case 2).
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fig10
A voiding cystourethrogram showed a partially obstructed urethra and absence of passive as well as active vesicoureteral reflux (Figure 10). An encrusted urethral stone (13 mm x 6 mm) with a speculated surface was extracted (Figure 10).
PMC6537023_03
Physical exam showing location of stone (case 3).
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fig11
On physical examination, the urethra meatus was normal; there was a hard, round, palpable mass in a tender penile urethra (Figure 11).
(a) Scout film showing penile stone (case 3). (b) VCUG, interruption of contrast (case 3).
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fig12
A scout film of the pelvis showed an image of a urethral stone (Figure 12(a)). Opacification of lower tract during VCUG confirmed the obstruction from the stone but no reflux (Figure 12(b)).
Urethral stone extraction (case 3).
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fig13
We removed the calculus via urethrotomy (Figures 13 and 14).
Stone removed (case 3).
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fig14
We removed the calculus via urethrotomy (Figures 13 and 14).
Postoperative dressing with urethral and suprapubic catheter (case 3).
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fig15
The two urinary catheters were kept on the abdomen after dressing (Figure 15).