A 25-year neglected giant anterior urethral stone associated with urethral diverticulum and urethrocutaneous fistula: A case report.

Abstract

Introduction: Urethral stone (US) is an uncommon disease that may be associated with other conditions. It's interesting if the patient neglected his disease after decades. This case report discusses the giant anterior urethral stone, as well as the neglect in the peripheral area.

Presentation of case: A 43-year-old man was referred to our hospital with a complaint of scrotal pain 4 days ago. He also complained about weak urine stream, a big-palpable mass, and a small opening in the scrotum that had appeared for many years. There was a history of recurrent urinary pain and purulent urine. Physical examination confirmed a solid-palpable and rounded mass with a meatus in the scrotum. Computed tomography (CT) revealed a giant stone. We performed an open surgery and extracted a 6.8 × 4.5 × 3 cm stone from the bulbous urethra and continued to urethral diverticulectomy.

Discussion: Neglected US could lead to serious complications if left untreated. This may be caused by lack of knowledge, low socioeconomic status, and negative stigma of urological diseases. Our case became complicated as the patient never came to seek medical help. Geographical and cultural limitations may also contribute to that situation. The current case was found to be more challenging due to limited resources and referral rejection. Finally, this case proved that open surgery can successfully treat the giant US and enhance the quality of life.

Conclusion: Immediate access to health care services in limited resource settings, is essential for early interventions of US in preventing further complications.