林志德, 侯鎮邦, 林友翔, 崔克宏, 張慧朗, 陳建綸

林口長庚醫院 外科部 泌尿科

Chih-Te Lin, Chen-Pang Hou, Yu-Hsiang Lin, Ke-Hung Tsui, Phei-Lang Chang,

Chien-Lun Chen

 

The 74 year-old patient had history of hypertension and diabetes mellitus. He  suffered from nocturia, frequency, urgency and dysuria for long time and he was under medication control. Recently the symptoms became more severe and bothered his daily life. He went to urologist outpatient clinic for clean intermittent catheterization for several times. The AUA score was 25 points. The Digital rectal exam revealed marked enlargement with smooth surface. Bladder echo showed huge prostate size with calcification inside and bladder diverticulum. The transrectal ultrasonagraphy revealed 135.8 gm with 87 gm T zone. The prostate calcification was also noted. The intravenous pyelogram showed bladder diverticulum and enlarged prostate gland with indentation on bladder base and prostate calcifications. The transurethral resection was done and the prostate stone was found inside prostate. The stone ananlysis revealed 94% calcium phosphate and 6% calcium oxalate. Another 65 year-old patient had history of hypertention and diabetes mellitus. He also received transurethral resection of prostate. The huge prostate was found and it’s composite were 95% calcium phosphate and 5% calcium oxalate.

Prostate cavity with prostatic giant calculus is very rare. Cystoscopy is an accurate screening method for its diagnosis. TURP combined with holmium laser lithotripsy can be employed, and intraoperative rectal examination should be taken to ensure complete removal of calculi.