A female patient with acute urinary retention caused by urethral lithiasis

Abstract

Acute urinary retention is a rare condition in women. It can be related to different disorders, rarely due to obstructive processes. We present a case of acute urine retention caused by lithiasis embedded in the female urethra, with its diagnosis, progress, complications and treatment. This is a 63-year-old patient, who comes to the emergency department with severe pain in the hypogastrium and without being able to urinate from the onset of pain, without other symptoms, a family history of lithiasis or other pathologies. She is treated with spasmoforte and parenteral hydration, with momentary improvement of symptoms. Several hours later, she presents to the emergency department due to intense and sustained pain in the hypogastrium, which radiates to the bilateral lumbar region, intense desire to urinate without being able perform micturition, with strong, repeated tenesmus, also accompanied by intense pain in the perineum and external genitalia. A domed meatus is observed due to the presence of urethral lithiasis, which makes a small prominence. Given the evaluation of the diameter of the meatus and the large size of the stone, it was decided to perform a meatoplasty and leave a Foley catheter. The patient progresses positively. In a follow-up consultation, at 21 days, the urinary catheter is removed, with continence and normal spontaneous evacuation. Kidney ultrasound and urinalysis are normal. The case shows the importance of an adequate anamnesis, physical examination and diagnostic tests.