Prostatolithotomy

Prostatolithotomy

What is Prostatolithotomy?

Prostatolithotomy involves the incision of the prostate for removal of a calculus.

Effects of Prostatolithotomy

In some men, infected prostate stones may cause recurrent urinary tract infections (UTIs) and make it difficult to cure bacterial prostatitis. The stones may have to be removed with surgery before UTIs or chronic prostatitis can be resolved.

Candidates for Prostatolithotomy

Prostatic calculi are extremely common in men over 50 years of age but infrequent in patients below 40 years and rare in children.

Your Consultation

Prostatic calculi rarely present as a clinical problem and their diagnosis is usually obtained by plain radiology or transrectal ultrasonography. Treatment of the calculi is often not required, but usually involves transurethral resection although ESWL with suprapubic percutaneous extraction has been described.

Large prostatic calculi detected pre-operatively in the presence of small amounts of resectable prostatic tissue should be treated and extracted as aggressively and completely as possible at the first intervention to avoid the necessity of repeat intervention.

The Prostatolithotomy Procedure

If a Prostatolithotomy is done under local anesthesia through the area between the anus and scrotum (perineum), no other special preparation is needed.

If the biopsy is done through the rectum, you may need to have an enema before the biopsy.

If the biopsy is done under general anesthesia, do not eat or drink anything for 8 to 12 hours before the biopsy. During preparation for the biopsy, an intravenous line (IV) is inserted in your arm, and a sedative medication is given about an hour before the biopsy.

For a Prostatolithotomy, a thin needle is inserted through the rectum (transrectal biopsy), through the urethra, or through the area between the anus and scrotum (perineum). A transrectal biopsy is the most common method used. The tissue samples taken during the biopsy are examined for cancer cells.

Recovery

Hospital stays range from one day to one week, depending upon the level of organ involvement and type of urologic surgery (open versus laparoscopic). Major urologic surgeries may require stents (temporary diversion of urine or feces) and catheters that are removed after surgery. Some surgeries are staged in two parts to accommodate the removal of diseased tissue, and the augmentation or reconstruction to replace function.

Risks

The risks of urologic surgery vary with the type of surgical procedure and the extent of organ involvement. Open surgery poses the standard surgery and anesthetic risks associated with strain on the heart and lungs. Risks of infection at the wound site accompany all surgeries, open and laparoscopic. The risk of injury to adjacent organs is higher in laparoscopic surgery.

Significant gains have been made in prostate surgery. Urinary control issues following prostate surgery, especially radical prostatectomy, have improved. However, postoperative urinary incontinence remains a significant risk, with 27% of patients in one study reporting the need for some kind of leakage protection. In the same study, only 14.2% of previously potent men reported the ability to achieve and maintain a postoperative erection that is sufficient for sexual intercourse.

FAQs

What are prostatic calculi?

Prostatic calculi are usually composed of calcium phosphate stones formed either by simple precipitation of prostatic secretions or calcification of the corpora amylacea. They may arise either spontaneously or as a result of inflammation, infection or obstruction.

What are the signs and symptoms of prostatic calculi?

Symptoms attributed to prostatic calculi are rare and include reduction of the urinary stream, lower back and leg pain, recurrent passage of calculi after TURP and orchitis.