We report the case of a 68-year-old man with a history of PSA of 9 ng/ml, a series of negative prostatic biopsies and TURP two years before his arrival at our service.
Postoperative bleeding requiring closure of the loop and admission to the intensive care unit was observed.
The material used in the proband was removed 72 hours later and the transurethral catheter was removed 14 days later.
In the following months the patient reported severe dysuria, pollakiuria, nocturia, mild intermittent hematuria and even hyperuricuria (10 episodes each month).
His quality of life was notably affected because he had ideas of suicide.
Urine analysis showed alkaline pH (8-9), positivity for nitrates and leukocytes persistently unchanged, although urine cultures were negative.
Creatinine and laboratory parameters were normal.
PSA was 7 ng/ml.
The cystourethrogram showed an irregular radiopaque image delimiting the proband space; the urethra and bladder were normal.
This image seemed hyperechoic with posterior acoustic sound on ultrasound.
Computed tomography showed a thick bladder wall and a hyperdense irregular prostate.
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Cystoscopy revealed multiple irregular calcifications adhered to and limited to the prostate as well as intense mucosal hyperemia of the bladder.
A transurethral resection of the calcified tissue was performed.
The Foley catheter was removed 24 hours after surgery obtaining almost immediate relief of symptoms.
The pathology report of more than 10 g of tissue showed: fibroadenomatous hyperplasia, chronic and acute prostatitis with consolidation and extensive areas of necrosis and infarction.
Crystal analysis, performed in two different laboratories, determined the presence of 60% ammonium phosphate magnesium hydroxide (struvinate), 30% ammonium urates, and 10% ammonium hydroxide-phosphate uraate and 10% ammonium chloride hexaate.
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After 12 months of follow-up the patient remains asymptomatic.
Urine analysis showed a pH of 5, without nitrates or hematuria or leukocyturia.
Urine cultures are negative.
