Nonclassical case of manifestation ofurolithiasis

In the general structure of kidney pathology, urolithiasis is the second most common after inflammatory diseases. Urolithiasis in the clinic is usually manifested by symptoms caused by a violation of the passage of urine through the urinary tract. The classic manifestation of urolithiasis is renal colic – a sudden attack of severe pain in the lumbar region, caused by impaired outflow of urine from the kidney. Rarely enough, urolithiasis manifests itself as urinary disorders, up to acute urinary retention, which are caused by the migration of calculus into the urethra. This article provides a clinical example of a nonclassical manifestation of urolithiasis in a patient who was admitted primarily with complaints of frequent urination, a feeling of incomplete emptying of the bladder, episodes of hematuria, which, after further examination, led to an inaccurate diagnosis and discharge of the patient for outpatient treatment. After 4 days, the patient developed a clinical picture of acute urinary retention, accompanied by pain and fever. Diagnosed with acute obstructive pyelonephritis, urolithiasis, stone of the membranous urethra, acute urinary retention. On the background of cystostomy drainage, the standard treatment of pyelonephritis was carried out, followed by optical contact lithotripsy of the urethral stone. Thus, it is important to carefully carry out a differential diagnosis in patients with symptoms of the lower urinary tract, to remember their nonspecific nature and about rare cases, which, among other things, may be caused by the migration of calculus into the urethra. Prolonged disturbance of the outflow of urine through the urinary tract can cause the development of an inflammatory process in the kidneys, irreversible loss of their functional ability and even death of the patient. For this reason, it is important to carefully carry out a differential diagnosis in patients with symptoms of the lower urinary tract, to remember their nonspecific nature and rare cases, which, among other things, may be caused by the migration of calculus into the urethra.

Abstract licence: CC BY-NC-ND

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