Stress urinary incontinence as a rare presentation of large prostatic stones in neurogenic bladder: implications and management

We report a case of a 38-year-old man with a background of a neglected neurogenic bladder, who presented with a recent onset history of stress urinary incontinence. He was diagnosed as having large prostatic stones along with a low-compliance, small capacity bladder and bilateral hydronephrosis with deranged renal functions. As self-catheterisation was not possible due to obstructing prostatic stones, holmium-YAG laser lithotripsy of prostatic stones was performed as initial procedure that resulted in complete resolution of stress incontinence as well. Successful gastrocystoplasty was performed as a second step to deal with the underlying condition of neurogenic poorly compliant bladder. The present case describes the successful endoscopic management of prostatic calculi using holmium-laser lithotripsy and draws attention to other important issues that need to be addressed in certain special situations like neurogenic bladder.