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10) Open exploration is the most invasive but also the most successful technique in the form of external urethrotomy or suprapubic cystostomy.
For large, impacted urethral stones, external urethrotomy combined with externally pneumatic lithotripsy may prevent long urethral incisions.
Whereas urethroscopic lithotripsy is the first choice for all urethral stones, external urethrotomy is recommended for large, impacted anterior urethral stones, along with urethral strictures and diverticula.
Our aim was to describe a patient with two large penile and prostatic urethral stones who received external urethrotomy combined with extracorporeal pneumatic lithotripsy, as well as discuss this treatment option according to the current literature.
Although endoscopic treatments with different types of lithotripsy are the accepted standard therapies, external urethrotomy can be performed for large and impacted stones with or without thral stricture and diverticula.
We performed external urethrotomy for a penile urethral stone after failed endoscopic treatment, and pneumatic lithotripsy was performed via incision.

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