Giant prostatic calculi are rare with less than 20 cases reported in the literature so far. Here, we discuss the presentation, diagnosis, and surgical management of a 25-year-old male patient with giant prostatic stones associated with a large bladder stone resulting from an underlying neurogenic bladder secondary to spina bifida. The patient had a history of congenital spina bifida, hydrocephalus, and non-compliance with clean intermittent self-catheterization. The stones were diagnosed through imaging and cystoscopy, and open cystolithotomy was performed for stone removal. The patient had a successful postoperative recovery with improved renal function. The case highlights the association between prostatic calculi and bladder outlet obstruction, emphasizes the importance of addressing underlying conditions to prevent stone recurrence, and underscores the role of open surgery in managing large bladder stones accompanied by renal impairment.
Background Lower urinary tract symptoms (LUTS) are commonly experienced among ageing males. The increasing prevalence of late-onset hypogonadism suggests a possible relationship between serum testosterone and severity of LUTS. This study examines the association between serum testosterone and severity of lower urinary tract symptoms among Malaysian men, as reflected by the International Prostate Symptom Score (IPSS). Method A total of 163 men with LUTS were enrolled in a cross-sectional study in Hospital Canselor Tuanku Mukhriz, Malaysia. Full examination, IPSS, and serum total testosterone (TT) levels were evaluated. Categorical and continuous correlations were analyzed using chi-square test and age-adjusted Pearson’s partial correlation, respectively. Result Mean age was 66.25 (SD = 7.05), with mean serum TT of 16.74 nmol/L (SD = 6.32). Twenty eight percent (n = 46) had low testosterone levels. Severity of LUTS (mild, moderate, severe) was not found to be dependent on TT status (normal, low, severely low), (χ2 [4, N = 163] = 4.24, P = 0.37). Weak negative correlations between total IPSS and IPSS storage sub-score with serum TT levels were exhibited respectively (r = −0.17, P < 0.05; r = −0.17, P < 0.05). Conclusion Among elderly Malaysian men, severity of LUTS and TT status were not found to be associated, despite a weak negative correlation between IPSS and serum testosterone levels. Nonetheless, with a high prevalence of hypogonadal ageing men, further research regarding serum testosterone measurement among this population may be valuable as part of a multimodal approach to treatment.
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