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Background: Urethral calculi are rare and usually encountered in males with urethral pathology., Objective: To present our experience managing urethral calculi in a resource limited centre and review the literature., Methods: We did a chart review of management of patients with urethral calculi between January and April 2009, at Federal Medical Centre (FMC) Azare, Nigeria. We also reviewed the literature on this rare condition., Results: Four young adult male Nigerians between the ages of 17 and 27 years presented with varying degrees of urethral pain and palpable calculi in the anterior urethra. Two presented with acute retention of urine, but none had haematuria. The calculi were radio-opaque, located in the anterior urethra with no associated urethral pathology. Three were solitary and one multiple. The composition of the urethral calculi was a mixture of calcium oxalate calcium carbonate, magnesium phosphate, one has additional cystine but none had struvite or uric acid. Their sizes ranged between 1cm ×1.5cm and 1.5cm × 5.5cm. External urethrotomy was the method of treatment., Conclusion: Urethral calculi are rare in our setting, with no clear identifiable aetiological factors which suggests urinary schistosomiasisbeing associsted. The occurrence of urethral calculi appears to have a relationship with childhood urinary schistosomasis.

Background: Gallbladder perforation (GBP) is rare and as a complication of typhoid fever is extremely rare. We present two consecutive patients with GBP diagnosed incidentally at laparotomy., Method: Information on the management of two patients with gallbladder perforation seen at Federal Medical Centre Azare in June and October 2008 was extracted from their case records., Results: The two patients were both males aged 13 years and 16 years. They both presented with high fever of more than 2 weeks duration; and abdominal pain and distension. Both patients had features of generalised peritonitis. Pre-operative diagnoses of typhoid enteric perforation were made based on a positive Widal test. Intra-operative findings however, were that of bile peritonitis and gallbladder perforation. Both had cholecystectomy. Culture of the bile aspirate yielded Salmonella typhi., Conclusion: Gallbladder perforation secondary to typhoid fever should be considered as a differential diagnosis in patients with suspected typhoid enteric perforation in typhoid fever endemic region.

Background: Penile entrapment and subsequent strangulation is a serious injury that requires a prompt treatment to avoid gangrene., Objective: We report our experience dealing with a case of penile gangrene following strangulation by a metallic nut in a middle aged Nigerian., Methods: We summarise the case history, physical findings, investigations and operative treatment of a middle aged man who slipped a round metallic nut over his penis, entrapping it for five days causing strangulation and subsequent gangrene. The literature on penile entrapment, strangulation and gangrene is also reviewed., Results: The patient presented with acute urinary retention and had complete gangrene of the penis. Suprapubic cystostomy was done and he had total penile amputation and perineal urethrostomy, Conclusion: Entrapment of the penis leading to strangulation is a rare condition that needs urgent relief, otherwise penile gangrene sets in, the treatment of which has very serious consequences.