Korean J Urol.  2013 May;54(5):345-347. 10.4111/kju.2013.54.5.345.

Tricholithobezoar: An Unusual Late Complication of Neourethral Reconstruction in Aphallia

• Singh V
• Nagathan D
• Sinha RJ
• Gupta DK

• KMID: 2061518
• DOI: http://doi.org/10.4111/kju.2013.54.5.345

Abstract

An 18-year-old man born with aphallia had undergone phallic reconstruction in childhood followed by total urethral reconstruction with a buccal mucosal graft and groin-based pedicle (Singapore) flap urethroplasty at 13 years of age. The patient presented with obstructive voiding symptoms lasting 6 months followed by acute urinary retention. The results of a voiding cystourethrogram showed a filling defect in the distal urethra that had been reconstructed by use of the skin flap. On urethroscopy, a 3 cmx2 cm sized tricholithobezoar was seen in the distal urethra. Pneumatic lithotripsy followed by bulbar urethrolithotomy was performed in the same operation to extract the bezoar. The remaining hairs were mechanically epilated. The patient has been doing well for 6 months of follow-up.

Keyword

Bezoars; Epilation; Stone

MeSH Terms

Bezoars
Follow-Up Studies
Hair
Hair Removal
Humans
Lithotripsy
Skin
Transplants
Urethra
Urinary Retention

Figure

• 

  FIG. 1 (A) The voiding cystourethrogram shows a filling defect (arrow) in the distal urethra with proximal dilatation. (B) Urethroscopic image showing a smooth stone with adjacent hair in the lumen of the neourethra.

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  FIG. 2 (A) Intraoperative image showing fragmentation of a "tricholithobezoar" by use of pneumatic lithotripsy. (B) Fragmented stone sized 3 cm×2 cm with hair in its interstices.

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