Korean J Urol.  2009 Aug;50(8):819-821. 10.4111/kju.2009.50.8.819.

Large Prostatic Calculi Causing Urethral Obstruction

• Paick SH
• Yoon SW
• Baek M
• Kim HG
• Lho YS

• KMID: 1780489
• DOI: http://doi.org/10.4111/kju.2009.50.8.819

Abstract

Although prostatic calculi are common, complications are fortunately rare. Here, we report a case of prostatic calculi causing urethral obstruction. A 66-year-old man presented with severe voiding difficulty and urge incontinence. He was found to have multiple large prostatic calculi obstructing the prostatic urethra as well as several bladder calculi. Attempts at endoscopic removal were unsuccessful, which resulted in an iatrogenic urethral diverticulum due to fragmented calculi. The residual calculi and diverticulum were removed successfully by open surgery.

Keyword

Prostate; Urinary bladder; Calculi; Urethral obstruction

MeSH Terms

Aged
Calculi
Diverticulum
Humans
Prostate
Urethra
Urethral Obstruction
Urinary Bladder
Urinary Bladder Calculi
Urinary Incontinence, Urge

Figure

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  Fig. 1 KUB film showing multiple large calculi in the areas of the bladder and prostate.

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  Fig. 2 Endoscopic features of multiple prostatic calculi in the right and left prostatic fossae.

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  Fig. 3 KUB film showing persistent bladder and prostatic calculi. Multiple fragmented calculi are located at the bulbous urethra.

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  Fig. 4 KUB film showing no residual calculus within the urinary tract.

Reference

1. Menon M, Resnick MI. Walsh PC, Retik AB, Vaughan ED, Wein AJ, Kavoussi LR, Novick AC, editors. Urinary lithiasis: ethiology, diagnosis, and medical treatment. Campbell's urology. 2002. 8th ed. Philadelphia: Saunders Elsevier;3287–3289.

2. Klimas R, Bennett B, Gardner WA Jr. Prostatic calculi: a review. Prostate. 1985. 7:91–96.

3. Sutor DJ, Wooley SE. The crystalline composition of prostatic calculi. Br J Urol. 1974. 46:533–535.

4. Torres Ramirez C, Aguilar Ruiz J, Zuluaga Gomez A, Espuela Orgaz R, Del Rio Samper S. A crystallographic study of prostatic calculi. J Urol. 1980. 124:840–843.

5. Park HK, Kwak C, Kim SH, Jeong H, Lee SE. The effect of prostatic calculi detected by transrectal ultrasound on the level of serum prostate specific antigen. Korean J Urol. 2003. 44:649–654.

6. Wollin TA, Singal RK, Whelan T, Dicecco R, Razvi HA, Denstedt JD. Percutaneous suprapubic cystolithotripsy for treatment of large bladder calculi. J Endourol. 1999. 13:739–744.

7. Okeke Z, Shabsigh A, Gupta M. Use of Amplatz sheath in male urethra during cystolitholapaxy of large bladder calculi. Urology. 2004. 64:1026–1027.

8. Bedir S, Kilciler M, Akay O, Erdemir F, Avci A, Ozgök Y. Endoscopic treatment of multiple prostatic calculi causing urinary retention. Int J Urol. 2005. 12:693–695.

9. Kim BH, Kim KJ, Kim SJ, Shin SM, Yoo ST, Sung LH, et al. A case of a giant prostatic calculus with bladder stones. Korean J Urol. 1999. 40:1720–1722.

10. Shah SK, Chau MH, Schnepper GD, Lui PD. Open prostatolithotomy for the management of giant prostatic calculi. Urology. 2007. 70:1008.