An unusual coexistence of vesicourethral collar stud and bulbar urethral diverticular calculi

Abstract

Urolithiasis is a common urological condition and an important affliction of the urinary tract; however, urethral calculi account for a small fraction of stones in the entire urinary tract. The dual occurrence of a vesicourethral collar stud calculus and a bulbar urethral diverticula calculus is exceptionally rare. We report the case of a 50-year-old man who presented with lower urinary tract symptoms that culminated into acute urine retention, which was relieved by suprapubic cystostomy after a failed attempt at urethral catheterization. His pelvic X-ray revealed vesicourethral collar stud and bulbar urethral calculi. There was no urethral stricture on retrograde urethrogram. The patient underwent cystolithotomy, urethrolithotomy, diverticulectomy, and urethroplasty. He was treated for suprapubic surgical site infection during the postoperative period. His voiding remained normal on removal of urethral catheter and he had no lower urinary tract symptoms at the last follow-up. Collar stud vesicourethral calculus coexisting with bulbar urethral diverticular calculus is rare. Appropriate patient work-up followed by cystolithotomy, urethrolithotomy, diverticulectomy with urethroplasty alleviates lower urinary tract symptoms.