A urethral stone is an uncommonly encountered form of urolithiasis where a mineral stone becomes impacted directly in the urethra—the fibromuscular tube responsible for conducting urine out of the bladder and body. Accounting for less than 1% to 2% of all urinary tract stone cases, urethral stones are significantly more frequent in men due to their longer, narrower urethral anatomy.
Most urethral stones originate higher up in the kidneys or bladder (migrated stones) and become trapped at narrow anatomical points during voiding, such as the prostatic urethra, bulbar urethra, or external meatus. Dr. Sumit Chaudhari, Consultant Urologist, Andrologist, Laparoscopic & Renal Transplant Surgeon at Usha Urology & Andrology Clinic in Pimple Saudagar, Pimpri-Chinchwad, provides rapid-response endoscopic and laser interventions to relieve obstruction and clear urethral stones safely.
Urethral stones rarely form primary calcifications inside the urethra itself unless structural abnormalities trap stagnant urine:
Migrated Kidney or Bladder Stones: A stone originating in the renal pelvis or bladder travels down during urination and gets physically wedged in the urethral lumen.
Urethral Strictures: Narrowing of the urethra due to previous trauma, infection, or catheterization creates a anatomical bottleneck where tiny crystals aggregate.
Urethral Diverticulum: A small sac-like pouch extending from the urethral wall where urine pools, leading to localized (stasis-induced) stone formation.
Prostatic Enlargement (BPH): An enlarged prostate constricts the prostatic segment of the urethra, increasing the risk of stone impaction.
The sudden blockage caused by a trapped urethral stone creates distinct and severe distress:
Sudden Acute Urinary Retention: Sudden, complete inability to pass urine despite a painful, full bladder feeling.
Severe Localized Pain: Sharp, tearing pain felt directly in the perineum, penis, scrotum, or lower pelvic floor.
Splitting or Dribbling Stream: Urine flow becomes severely diminished, painful, spraying, or reduced to drop-by-drop dribbling.
Urethral Bleeding (Urethrorrhagia): Bright red blood appearing at the urethral opening independently of or alongside voiding.
Palpable Hard Mass: In anterior urethral blockages, a hard nodule may be felt along the underside of the penis or perineum.
Treatment depends on the stone's exact location (anterior vs. posterior urethra), size, and whether an underlying stricture is present:
| Treatment Category | Clinical Location | Procedure & Technique |
| In-Office Extraction / Meatotomy | External Urethral Meatus | Micro-forceps removal under local anesthesia for stones lodged at the tip of the urethra |
| Retrograde Push-Back & Laser Lithotripsy | Posterior Urethral Stones | The stone is gently pushed back into the bladder using a cystoscope and pulverized via Holmium laser |
| Transurethral Cystolitholapaxy | Mid-to-Prostatic Urethra | Endoscopic fragmentation using laser or pneumatic probes directly within the urethral lumen |
| Open / Reconstructive Surgery | Large Impacted Stones with Severe Stricture | Open surgical extraction coupled with urethral stricture repair (urethroplasty) when endoscopic passage is blocked |
Dr. Sumit Chaudhari (MBBS, MS, DNB Urology) is a highly skilled Consultant Urologist, Andrologist, Laparoscopic & Renal Transplant Surgeon. Practicing at Usha Urology & Andrology Clinic in Pimple Saudagar, Pimpri-Chinchwad, he specializes in endourology, complex stricture urethral surgeries, laser stone removal (RIRS, URSL, PCNL), laser prostate surgery (TURP/HoLEP), and emergency urological management.
Q: Can a urethral stone cause permanent damage if left untreated?
A: Yes. An untreated urethral stone causes acute urinary retention, which can lead to bladder over-distension, severe urinary tract infections, urethral tissue necrosis, or retrograde pressure injury to the kidneys. Immediate urological care is critical.
Q: Is urethral stone removal performed under anesthesia?
A: Yes. Modern endoscopic procedures like retrograde push-back and laser lithotripsy are performed under regional or general anesthesia to ensure complete comfort during the procedure.
Q: Why are urethral stones much more common in men than women?
A: The male urethra is significantly longer (approx. 18–20 cm) and has natural anatomical narrowings (such as the prostatic and bulbar segments), making stone impaction much more likely compared to the short, straight female urethra (approx. 4 cm).
If you or a loved one experiences severe urethral pain or sudden inability to pass urine, seek medical evaluation immediately.
AboutMyClinic