Accidental prostatic stone finding after urinary catheterization failure during hernia surgery

Abstract

Urethral stones represent a rare cause of urinary obstruction and they are usually symptomatic. In older patients with bladder outlet obstruction, bladder stones are commonly found and managed accordingly. Intraprostatic stone formation is also a common finding in men with benign prostate hyperplasia but rarely is it a factor for obstruction. On the contrary, large stone formation in the prostatic urethra is a rare entity, and patients present with hematuria, dysuria, infection or retention in most of the cases. Patients previously submitted to urological procedures such as prostatectomy or lithotripsy, are at high risk of developing late complications and need a long follow-up. In cases with obstruction due to urethral stones the management is straightforward but in asymptomatic patients the diagnosis is usually missed or delayed. Therefore, careful evaluation of the patient is essential in order to prevent any unwanted situation such as catheterization failure. Authors’ present a case of an 82-year-old male who accidentally diagnosed with a large stone impacted in the prostatic cavity after urinary catheterization failure during a scheduled open hernia repair surgery. The patient had a history of previous open prostatectomy and he was completely asymptomatic. An emergency cystoscopic evaluation revealed the cause of the prostatic urethral obstruction. The urinary stone was subsequently managed endoscopically on the spot.