Recurrent Giant Prostatic Urethral Calculus: A Case Report and Mini-Review of the Literature

Naouar, Sahbi; Khalifa, Badreddine Ben; Braiek, Salem; Kamel, Rafik El

doi:10.14740/wjnu287w

Cited by 2 publications

(1 citation statement)

References 7 publications

(19 reference statements)

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“…Patients require long-term surveillance to avoid recurrent stone formation, which can include metabolic evaluation or treatment of predisposing factors such as urethral stenosis or diverticula [ 12 ]. Recurrence of prostatic calculi may be observed for reasons such as reformation of de novo calculi in prostate gland cavities, formation of new calculi, or incomplete excision of related diverticula [ 1 ].…”

Section: Discussionmentioning

confidence: 99%

Urethral Steinstrasse following Laser Lithotripsy of Prostatic Urethral Calculi

Den

Kerr

Dafashy

et al. 2018

Case Reports in Urology

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Symptomatic prostatic calculi are rare occurrences with several management options, the most popular of which is currently transurethral laser lithotripsy. This is a generally well-tolerated procedure with minimal complications. To date, no reported episodes of steinstrasse at the urethral level following prostatic calculi lithotripsy have been documented to our knowledge. We report a unique case of acute urinary retention secondary to obstructive calculi fragments following a transurethral laser lithotripsy of large prostatic calculi, further complicated by stricture at the fossa navicularis.

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Section: Discussionmentioning

confidence: 99%

Urethral Steinstrasse following Laser Lithotripsy of Prostatic Urethral Calculi

Den

Kerr

Dafashy

et al. 2018

Case Reports in Urology

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Hobnail-shaped primary prostatic urethral calculus due to urethral stricture disease

Anand,

Kesharwani,

Sema

et al. 2024

Formos J Surg

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Primary prostatic urethral calculi are different from true calculi of the prostate parenchyma. While the mechanism of formation of these stones is due to the prostatic secretions, corpora amylacea, or inflammation of the prostate, [1] the prostatic urethral calculi are found just proximal to the membranous segment of the urethra. These calculi either migrate from the upper urinary tract or may be autochthonous, that is, forming primarily in the prostatic urethra. [2] A man in his 40s presented with a history of poor stream, intermittency, straining, and a sense of incomplete voiding for 5 years. He was evaluated and treated with antibiotics, α-blockers, and phenazopyridine by multiple doctors. There was no history of constipation and his focused neurological examination was normal. However, on ultrasonography, a vesical calculus was identified. On plain radiography, the stone was found to have a unique shape like a hobnail (Fig. 1). There was no history of passage of any urinary calculus, and on computed tomography, there was no other calculus in the patient's urinary tract. Therefore, we planned to do a urethrocystoscopy and cystoscopic stone fragmentation.On urethroscopy, we found a midbulbar urethral stricture with moderate spongiofibrosis (Fig. 2) and did a direct vision internal urethrotomy for the stricture; thereafter, the stone was pushed into the bladder and a percutaneous cystolithotripsy was done for stone removal. At 6 months, the patient is voiding well and asymptomatic.The primary prostatic urethral calculi are small, multiple, and generally struvite stones and form in the urethra due to some obstructive lesion or in a poorly drained cavity due to obstruction, stagnation, infection, or inflammation as the predisposing factors, as in the case of urethral stricture, urethral diverticulum, phimosis, or neurogenic bladder. [2] These stones belong to group IV of the Young classification and type A of the Joly classification. [3,4] Because the shape of the calculus in our case was very much characteristic of a primary prostatic urethral calculus and the calculus seems to mold to the shape of the prostatic urethra, we performed a urethroscopy before committing the patient for surgery. [5] Urethroscopy is an important investigation to diagnose the urethral obstruction or diverticula, which may be difficult to diagnose by contrast urethrography in the presence of a preexisting radio-opaque shadow of calculus, which is conforming to the shape of prostatic urethra, opacifying the complete prostatic urethra. Urethroscopy is also important as it can simultaneously be curative in these cases.

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Recurrent Giant Prostatic Urethral Calculus: A Case Report and Mini-Review of the Literature

Cited by 2 publications

References 7 publications

Urethral Steinstrasse following Laser Lithotripsy of Prostatic Urethral Calculi

Urethral Steinstrasse following Laser Lithotripsy of Prostatic Urethral Calculi

Hobnail-shaped primary prostatic urethral calculus due to urethral stricture disease

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