Giant Urethral Calculus

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THE occurrence of calculi within the male urethra is uncommon. LeComte1 encountered this condition seven times in a series of 2900 urologic cases. Debenham2 reported 40 cases of urethral calculi admitted to the London Hospital from 1910 to 1930, 3 patients being women and 37 men. Kini3 found only 1 case of calculi among 102 patients with stricture of the male urethra.

Urethral calculi are classified as primary or autochthonous and secondary or migratory calculi, depending on their site of origin. Autochthonous calculi occur more rarely and are usually formed in the urethra behind some obstruction or diverticulum. Secondary calculi are formed in other parts of the urinary tract and migrate to the urethra. Differentiation between autochthonous and secondary calculi may be difficult. According to Culver,4 Legueu believed that every urethral calculus originated in the kidney or bladder and became urethral secondarily. Stevens5 admits that autochthonous calculi are less common than secondary calculi and that their formation depends upon certain abnormal local conditions such as stricture, congenital or acquired dilations, diverticula, and prostatic hypertrophy. The recent work of Wilson, Benjamin, and Leahy6 demonstrating the production of urethral calculi in newborn rats by injection of estradiol raises the question of endocrine influence upon urethral calculi.

Most authors agree that migratory stones have a nucleus of uric acid or calcium oxalate, while autochthonous stones are phosphatic in composition and uniform in structure, being formed in infected urine.7,8,9

Case Report

A man, aged 66, was admitted to the Cleveland Clinic on August 11,. . .



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