URETHRAL OBSTRUCTION DUE TO PROTRUDING PROSTATIC CALCULI

A 70-year-old man presented in sudden urinary retention. He had no history of hematuria, urgency, frequency or strangury. On rectal examination the prostate gland was enlarged and several localized areas of stony hardness were noted, Urine examination revealed microscopic hematuria and leukocyte casts but no bacteriuria. Imaging study demonstrated multiple horseshoe and ring shaped prostatic calculi and a few stones in the urethra (fig. 1) but no upper urinary tract calculi. Suprapubic cystostomy was performed and a 16F balloon catheter was inserted using a metal stylet. Cystourethroscopy revealed calculi protruding into the pars prostatica of the urethra near the bladder neck and a fistula between the urethra and prostatic middle lobe (fig. 2) but no urethral diverticula or foreign bodies. We inserted the resectoscope