Abstract

Urethral stones are rare, accounting for less than 1% of all urinary system stones. These stones may present with obstructive symptoms or remain asymptomatic. Hair-bearing urethral diverticula, which can form after surgical interventions such as hypospadias repair, are an uncommon cause of urethral stone formation. However, urethral stones leading to infertility are extremely rare.

A 38-year-old male patient presented to the urology outpatient clinic with complaints of infertility. Physical examination revealed a palpable mass in the penoscrotal region. Further evaluations and imaging identified this mass as a urethral stone within a hair-bearing urethral diverticulum. The patient"s history revealed a childhood hypospadias repair. Open surgery was performed for stone removal and diverticulectomy. Semen analysis at the six-month postoperative follow-up showed an improvement in semen volume from 1 mL preoperatively to 2.5 mL, reaching normal levels. Additionally, nine months after the procedure, the patient"s spouse was confirmed to be pregnant. Long-term follow-up revealed no postoperative complications.

This case highlights the importance of considering urethral pathologies in infertile patients with a history of urethral surgery. Such conditions can be effectively treated with open surgery, potentially restoring fertility.