Antegrade in situ Lasering of Distal Urethral Stone: A Novel Technique

Main Article Content

Muhammad F. Khan
Mina Awad
Soumya Misra


Different techniques are available to manage patients with urethral stones; varying from a conservative approach with spontaneous passage to open procedures. Alternative techniques include milking of stone, instilling local anesthetic jelly, pushing bang approach coupled with extracorporeal shock wave lithotripsy, lasertripsy and electrohydraulic lithotripsy. We describe a 55-year-old male patient who presented with fournier gangrene of perineum, penis and scrotum. Extensive debridement of superficial layers of perineum, scrotum and penis was performed. We put a suprapubic catheter, as per standard protocol. Thereafter, this patient had plastic surgery operations for graft placement. However, in the follow-up patient could not pass urine through urethra. Cystoscopic examination under general anesthesia revealed a stone in the distal urethra. We used a novel technique to remove this stone via an antegrade approach through the suprapubic tract and lasering the stone with holmium laser; thus avoiding open procedure and its associated complication (s). Exceptional circumstances demand thinking out of the box and in suchcases before considering open surgery one should consider this technique for the safe removal of stone.

Urethral stones, laser, suprapubic tract, fournier gangrene, antegrade approach.

Article Details

How to Cite
Khan, M. F., Awad, M., & Misra, S. (2020). Antegrade in situ Lasering of Distal Urethral Stone: A Novel Technique. Asian Journal of Research and Reports in Urology, 3(1), 1-4. Retrieved from
Original Research Article


Kamal BA, Anikwe RM, Darawani H, et al. Urethral calculi: presentation and management. BJU International 2004;93 (4):549-52.

Aus G, Bergdahl S, Hugosson J, et al: Stone formation in theprostatic urethra after cryotherapy for prostate cancer. Urology. 1997;50.

Verit A, Savas M, Ciftci H, et al. Outcomes of urethral calculi in patients in anendemic region and an undiagnosed primary fossa navicularis calculus. Urol Res. 2006;34.

El-Sharif and Prasad, Br J Urol. Treatment of urethralstones by retrograde manipulation and extracorporeal shock wave lithotripsy. 1995;76(6):761-4.

Maheshwari PN, Shah HN. In-situ holmium laser lithotripsy for impacted ureteral calculi. J Endourol. 2005;l19.

Walker BR, Hamilton BD. Urethral calculi managed with transurethral Holmium laser ablation. J Pediatr Surg. 2001;36:E16.

Rodriguez Martinez JJ, Perez Garcia FJ, Martinez Gomez FJ, et al. Multipleurethral lithiasis: Report of a case. Arch EspUrol. 2000;53.

El-Sharif AE, El-Hafi R. Proposed new method for no operative treatment of urethral stones. J Urol. 1991;146.

Atikeler MK, Yüzgeç V, Geçit I, et al: Urethral stone street. Int Urol Nephrol. 2005;37.

Singh I, Hemal AK. Recurrent urethral hairball and stone in a hypospadiac: Management and prevention. J Endourol. 2001;15.

Gokce G, Topsakal K, Ayan S, et al. Case report: No obstructive giant urethral stone with two safety pins. Int Urol Nephrol. 2004;36.

Lu YM, Chien TM, Yeh HC, et al. Ante grade cystoscopic light source guided laser urethrotomy for the treatment of completely obliterated urethra. Urological Science. 2017;28(1):32-35.