title: [Giant prostatic calculus with neurogenic bladder disease and prostate diverticulum: a case report and review of the literature].
abstract: OBJECTIVE
  To study the etiology, clinical manifestation, diagnosis and treatment of giant prostatic calculus with neurogenic bladder disease and prostate diverticulum.
  
  
  METHODS
  We retrospectively analyzed the clinical data of a case of giant prostatic calculus with neurogenic bladder disease and prostate diverticulum and reviewed the relevant literature. The patient was a 37-year-old man, with urinary incontinence for 22 years and intermittent dysuria with frequent micturition for 9 years, aggravated in the past 3 months. He had received surgery for spina bifida and giant vesico-prostatic calculus. The results of preoperative routine urinary examination were as follows: WBC 17 -20/HPF, RBC 12 - 15/HPF. KUB, IVU and pelvic CT revealed spina bifida occulta, neurogenic bladder and giant prostatic calculus.
  
  
  RESULTS
  The patient underwent TURP and transurethral lithotripsy with holmium-YAG laser. The prostatic calculus was carbonate apatite in composition. Urinary dynamic images at 2 weeks after surgery exhibited significant improvement in the highest urine flow rate and residual urine volume. Seventeen months of postoperative follow-up showed dramatically improved urinary incontinence and thicker urine stream.
  
  
  CONCLUSIONS
  Prostate diverticulum with prostatic giant calculus is very rare, and neurogenic bladder may play a role in its etiology. Cystoscopy is an accurate screening method for its diagnosis. For the young patients and those who wish to retain sexual function, TURP combined with holmium laser lithotripsy can be employed, and intraoperative rectal examination should be taken to ensure complete removal of calculi.
authors: Tianjin Institute of Urology, Tianjin Key Laboratory of Urology, Department of Urology, The Second Hospital of Tianjin Medical University, Tianjin 300211, China.
authors: Xiao-Shi
authors: XS
authors: Li
authors: Chang-Yi
authors: CY
authors: Quan
authors: Gang
authors: G
authors: Li
authors: Qi-Liang
authors: QL
authors: Cai
authors: Bin
authors: B
authors: Hu
authors: Jiu-Wei
authors: JW
authors: Wang
authors: Yuan-Jie
authors: YJ
authors: Niu
mesh_terms: D000328:Adult; D002137:Calculi / Q000150:complications*; D004240:Diverticulum / Q000150:complications*; D006801:Humans; D008297:Male; D011469:Prostatic Diseases / Q000150:complications*; D001750:Urinary Bladder, Neurogenic / Q000150:complications*