Transrectal voiding sonourethrography for diagnosis of a prostatic urethral calculus.

bstructive uropathy is a common clinical problem, and urethral calculi constitute the least common form of calculous disease leading to obstructive uropathy. Urethral calculi may originate anywhere in the urinary tract, usually the bladder, and then migrate to the urethra. The clinical presentation is variable. Patients may have acute retention, dysuria, or a weak urine stream.1 Sonography is a useful technique in detecting urethral calculi because urethral stones are easily identified by sonographic examination. Urethral calculi are most often identified in the prostatic urethra but may also be seen in the penile urethra. Sometimes it is difficult to differentiate prostatic urethral calculi from prostatic calcifications.2,3 Therefore, this condition makes diagnosis cumbersome. Transrectal voiding sonourethrography or a trans-scrotal approach (which is generally used for urethral strictures) can be used liberally in this situation. Here we describe our experience with the value of real-time transrectal voiding sonourethrography in detecting a prostatic urethral calculus.