Urethral calculus after radical prostatectomy: the importance of urethroscopy in evaluation of voiding disturbance
Michael K Ng, Nathan Lawrentschuk, Andrew Troy
Am J Case Rep 2008; 9:237-239
Background: Urethral calculi are uncommon, and are generally a result of proximal calculi migrating distally. There are only 3 prior reports of intravesical calculi forming on sutures post radical prostatectomy, causing voiding disturbance.
Case Report: A 49-year-old man presents 8 months after radical retropubic prostatectomy with voiding disturbance, initially assumed to be secondary to anastamotic stricture. On further examination, an ovoid mass was found at the level of the glans. Subsequent urethroscopy revealed an impacted urethral calculus to be the cause of the voiding disturbance. There was no evidence of stricture or foreign material at the anastamotic site. Examination of the urethra did not reveal any anatomic abnormality to suggest de novo formation of urethral calculus. Voiding pattern returned to normal after removal of the calculus.
Conclusions: Proper history and examination must be performed prior to every surgical procedure being undertaken, with urethroscopy an important diagnostic tool in the investigation of voiding disturbance post radical prostatectomy. Although anastamotic stricture is a common cause of voiding disturbance post radical prostatectomy, other rare causes do exist and must be kept in mind.
Keywords: radical prostatectomy, Urethra, calculus