Posttraumatic Urethral Stricture Complicated with Giant Vesical Calculus: Radiologic Findings and a Case Report

Urethral stricture is a narrowing of the urethra caused by scar tissue formation or inflammation that restrict the flow of urine and can lead to various urinary problems.

Giant vesical calculus is an unusually large calculus formed within the urinary bladder, typically weighing more than 100 grams or measuring over 4 cm in diameter, this develops due to long-standing urinary stasis, infection or obstruction.

This is a 35-year-old man who presented on account of inability to pass urine following trauma to the groin, suprapubic pain and discomfort, abnormal sensation radiating to the scrotal sacs and bilateral lumbar region pain and discomfort for almost four years duration. He had suprapubic urethral catheter insitu, and came for plain pelvic radiograph, retrograde urethrocystography (RUCG) and micturating cystourethrography (MCUG).

The plain radiograph demonstrated a pyramidal shaped opacity of calcific density in the pelvic cavity measuring about 68mm x 40mm in craniocaudal and mediolateral dimensions. The RUCG demonstrated a complete stricture at the bulbomembranous urethra, while MCUG demonstrated the previously described calculus with nondemonstration of the posterior urethra and bilateral moderate vesico-ureteric reflux.

A diagnosis of severe and complete posttraumatic stricture at the bulbomembranous urethra with associated giant vesical calculus and bilateral vesicoureteric reflux in a 35-year-old man was established. We present a case of giant vesical calculus in a patient with posttraumatic urethral stricture due to its rare occurrence, peculiar presentation and to review the literature.