We present a case of Alkaptonuria (AKU) presented with severe lower urinary tract symptoms (LUTS) secondary to extensive prostatic calculi deposited in the para prostatic diverticulum. Prostatic calculi are seen in chronic prostatitis, chronic pelvic pain syndrome and benign prostate hyperplasia; however, in patients with AKU, prostatic calculi and/or calcifications are more extensive. A para prostatic diverticulum is a rare entity in males; however, it should be considered in patients with AKU based on this case report.
A patient with AKU presented with extensive prostatic calculi that were deposited in para prostatic diverticulum, urethra and urinary bladder. The stones were successfully managed endoscopically.
Paraprostatic diverticula or urethral diverticula are rare entities. They may be congenital or acquired due to recurrent Urinary Tract Infections (UTIs) or distal urethral obstruction. The distal obstruction of the urethra secondary to stones was the most likely etiology of the paraprostatic diverticulum in our case. The possible mechanisms behind stone formation in our case were chronic stasis and urinary infection within a urethral diverticulum proximal to the urethral obstruction.
This case sums a rare case of AKU and paraprostatic diverticular stones; in addition, it highlights the role endoscopic management of prostatolithiasis in AKU patient.
International journal of surgery case reports. 2017 Jul 25 [Epub ahead of print]
Husam M F Masoud, Hussam H Alhawari, Nosibah T Alryalat, Muayyad M Murshidi, Mujalli M Murshidi
Jordan University Hospital, Queen Rania Street, Amman 11942, Jordan. Electronic address: ., Jordan University Hospital, Queen Rania Street, Amman 11942, Jordan. Electronic address: ., Jordan University Hospital, Queen Rania Street, Amman 11942, Jordan. Electronic address: ., Jordan University Hospital, Queen Rania Street, Amman 11942, Jordan. Electronic address: ., Jordan University Hospital, Queen Rania Street, Amman 11942, Jordan. Electronic address: .