Mechanisms of Delayed Lower Urinary Tract Stone Formation

Materials and methods:We analysed Holmium Laser Enucleation of Prostate (HOLEP) database consisting of 1300 patients who presented more than 18 months after undergoing the procedure with lower urinary tract symptoms (LUTS-voiding lower urinary tract symptoms, dysuria, haematuria, recurrent urinary tract infections-UTIs) second-ary to delayed lower urinary tract stone formation. Information was gathered from the case notes, imaging modalities, operation notes and pathology reports. Results:Three patients were identified who presented with delayed lower urinary tract stone formation 18 months after undergoing HOLEP. Case 1: A 68-year-old presented with a 4-cm mobile bladder stone on a retained prostatic fragment 29 months after HOLEP.Case 2: A 74-year-old presented with 2.5 cm bulbar urethral stone 18 months after HOLEP.Case 3: A 77-year-old presented with dystrophic calcification of the entire prostatic fossa 60 months after HOLEP. Conclusion:Delayed lower urinary tract stone presentation is unusual after HOLEP. Recurrent urethral pain, recurrent UTI, gross haematuria and voiding lower urinary tract symptoms in the presence of a lower urinary tract stone (bladder, prostate and urethra) with a radiolucent centre on a background of HOLEP should raise the suspicion that this may represent calcification on a prostatic tissue fragment or dystrophic calcification of the residual prostate/prostatic fossa. Careful morcellation, inspection of the prostatic fossa on withdrawing the morcellator for large residual prostate fragments still attached to the prostatic bed/bladder neck or simply stuck to the fossa (usually in a clot) will reduce the risk of retainment of such a significant prostatic fragment that can potentially cause complications in the future.

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Prevalence of lower urinary tract symptoms (LUTS) among young age medical population

IIUM Medical Journal Malaysia ◽

10.31436/imjm.v10i1.700 ◽

2020 ◽

Vol 10 (1) ◽

Author(s):

Zalina N ◽

Aruku N ◽

Azura N ◽

Shahida N ◽

Akhmarina N ◽

...

Keyword(s):

Urinary Incontinence ◽

Urinary Tract ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Public Awareness ◽

Young Age ◽

Personal Hygiene ◽

Urinary Tract Symptoms ◽

Tract Infections ◽

Lower Urinary

Introduction: Frequency of lower urinary tract symptoms (LUTS) in young age women is not well studied. It is said to be common among female elderly and multiparous population. The aim of this study is to obtain the prevalence of LUTS among nulliparous students in relation to their personal hygiene. Materials and methods: This is a prospective cross-sectional study conducted among 200 nulliparous medical and nursing students aged between 18-28 years using standardized questionnaires. Urine samples were also collected from students to detect urinary tract infections. Results: The complete data sets of 146 students were analyzed. All of them were nulliparous, single and not sexually active. The prevalence of LUTS was 52.7% consist of over-active bladder, urinary incontinence (UI) and voiding difficulty respectively (51.3%, 34.9% and 45.2%). The most common type of UI was stress urinary incontinence which was 21.9% followed by 11.6% of urgency incontinence. Conclusion: The prevalence of LUTS among young age population is high at 52.7%. Public awareness regarding LUTS and availability of treatment is needed.

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Multiple stones in neobladder: Case report and literature review

Urologia Journal ◽

10.1177/0391560319850427 ◽

2019 ◽

Vol 86 (4) ◽

pp. 216-219 ◽

Cited By ~ 1

Author(s):

Alessandro Tafuri ◽

Antonio B Porcaro ◽

Akbar N Ashrafi ◽

Maria Angela Cerruto ◽

Nelia Amigoni ◽

...

Keyword(s):

Urinary Incontinence ◽

Urinary Tract ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Orthotopic Neobladder ◽

Radical Cystoprostatectomy ◽

Urinary Tract Symptoms ◽

Tract Infections ◽

Abdominal Fullness ◽

Lower Urinary

Introduction: Neobladder urolithiasis is a rare but important long-term complication of orthotopic urinary diversion. It may be asymptomatic and can be discovered as an incidental finding on a radiological investigation. However, when symptoms occur, they may include lower abdominal pain, dysuria, hematuria, and lower urinary tract symptoms. Case description: We report the case of a 63-year-old male patient with irritative lower urinary tract symptoms, lower abdominal fullness, urinary incontinence, fecaluria, and urinary loss from the left inguinal fold 12 years after a radical cystoprostatectomy with a orthotopic neobladder. Computed tomography scan and urethrocystography showed a distended pouch with multiple large stones, an enterovesical fistula, and neovesicocutaneous fistula. The fistulae were successfully managed conservatively with the placement of a Foley catheter. After 3 months, open cystolithotomy was performed and approximately 50 stones with dimensions varying from 5 mm to 5 cm, with a total weight of 890 g, were removed. After a 1-year follow-up, the patient did not report pain, urinary tract infections, or symptoms suggestive of fistula and imaging evaluation confirmed no recurrence of neobladder stones. Conclusion: Neobladder stones may present with various symptoms. Our patient had irritative lower urinary tract symptoms, lower abdominal fullness, urinary incontinence, fecaluria, and urinary loss from the left inguinal fold 12 years after a radical cystoprostatectomy with a orthotopic neobladder. Our experience demonstrates that open cystolithotomy is an effective intervention for the removal of large stones in neobladder.

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Minimally invasive management of a symptomatic case of Zinner’s syndrome: Laparoscopic seminal vesiculectomy and ipsilateral nephroureterectomy

Archivio Italiano di Urologia e Andrologia ◽

10.4081/aiua.2019.1.58 ◽

2019 ◽

Vol 91 (1) ◽

pp. 58-59

Author(s):

Emanuele Corongiu ◽

Pietro Grande ◽

Valerio Olivieri ◽

Giorgio Pagliarella ◽

Flavio Forte

Keyword(s):

Urinary Tract ◽

Seminal Vesicle ◽

Lower Urinary Tract Symptoms ◽

Lower Urinary Tract ◽

Left Kidney ◽

Perineal Pain ◽

Urinary Tract Symptoms ◽

Patient Reported ◽

Tract Infections ◽

Lower Urinary

Introduction: Zinner syndrome is a rare developmental anomaly of the Wolffian (mesonephric) duct which is characterized by a triad of obstruction of the ejaculatory duct, the ipsilateral seminal vesicle cyst, and the ipsilateral renal agenesis. Usually is totally asymptomatic, however it can also determine symptoms such as lower urinary tract symptoms, perineal pain, ejaculatory disorders such as painful ejaculation or hematospermia, and infertility. Case report: We present a case of a 51 years old men with a 3-year history of lower urinary tract symptoms, perineal pain, obstructed defecation, recurrent urinary tract infections and infertility. CT scan showed a voluminous cystic neoformation of the left seminal vesicle, hypoplasia of the left kidney and ipsilateral ureteronephrosis. The mass was removed using laparoscopic “en block” seminal vesiculectomy with associated ipsilateral nephroureterectomy. No post-operative complications occurred. At 2-month post-operative control the patient reported an improvement of urinary and rectal symptoms.

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