Recurrent Dystrophic Calcification of the Prostatic Resection Cavity After Transurethral Resection of the Prostate: Clinical Presentation and Endoscopic Management.

Zumstein V; Betschart P; Müllhaupt G; Jochum W; Schmid HP; Abt D

doi:10.1089/cren.2017.0058

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Journal article

Recurrent Dystrophic Calcification of the Prostatic Resection Cavity After Transurethral Resection of the Prostate: Clinical Presentation and Endoscopic Management.

Zumstein V Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Betschart P Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Müllhaupt G Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Jochum W Institute of Pathology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Schmid HP Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Abt D Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland.

2017-07-25

Published in:

Journal of endourology case reports. - 2017

English Background: Dystrophic calcification (DC) can occur as a reaction to tissue damage and necrosis. So far, this has never been described as a complication after conventional transurethral resection of the prostate (TURP). Case Presentation: We report on a 59-year-old man who underwent uncomplicated monopolar TURP for lower urinary tract symptoms caused by benign prostatic hyperplasia. The patient showed an excellent course up to 5 weeks after the initial operation. Afterward he suffered from a rapid onset of irritative and obstructive voiding symptoms and pain. Complete DC of the prostatic resection cavity was found by cystoscopy and recurred quickly twice after Re-TURP despite anti-inflammatory treatment and normal urinary and metabolic findings. Complete recovery was only achieved by gently scraping off the calcifications avoiding further trauma to the residual prostatic tissue. Conclusion: In rare cases, delayed occurrence of irritative and obstructive voiding symptoms after TURP can be caused by DC of the prostatic resection cavity and might be misinterpreted as post-TURP infection. The pathomechanism of DC and the presented case suggest minimizing tissue trauma by cautious removal of calcifications rather than performing extensive Re-TURP.

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