Zumstein Valentin, Betschart Patrick, Müllhaupt Gautier, Jochum Wolfram, Schmid Hans-Peter, Abt Dominik
Department of Urology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
Institute of Pathology, Kantonsspital St. Gallen, St. Gallen, Switzerland.
J Endourol Case Rep. 2017 Jun 1;3(1):81-83. doi: 10.1089/cren.2017.0058. eCollection 2017.
Dystrophic calcification (DC) can occur as a reaction to tissue damage and necrosis. So far, this has never been described as a complication after conventional transurethral resection of the prostate (TURP). We report on a 59-year-old man who underwent uncomplicated monopolar TURP for lower urinary tract symptoms caused by benign prostatic hyperplasia. The patient showed an excellent course up to 5 weeks after the initial operation. Afterward he suffered from a rapid onset of irritative and obstructive voiding symptoms and pain. Complete DC of the prostatic resection cavity was found by cystoscopy and recurred quickly twice after Re-TURP despite anti-inflammatory treatment and normal urinary and metabolic findings. Complete recovery was only achieved by gently scraping off the calcifications avoiding further trauma to the residual prostatic tissue. In rare cases, delayed occurrence of irritative and obstructive voiding symptoms after TURP can be caused by DC of the prostatic resection cavity and might be misinterpreted as post-TURP infection. The pathomechanism of DC and the presented case suggest minimizing tissue trauma by cautious removal of calcifications rather than performing extensive Re-TURP.
营养不良性钙化（DC）可作为对组织损伤和坏死的一种反应而发生。迄今为止，这从未被描述为传统经尿道前列腺切除术（TURP）后的一种并发症。我们报告一例59岁男性，其因良性前列腺增生导致的下尿路症状接受了无并发症的单极TURP。该患者在初次手术后直至5周病情进展良好。之后，他迅速出现刺激性和梗阻性排尿症状及疼痛。经膀胱镜检查发现前列腺切除腔完全钙化，尽管进行了抗炎治疗且尿液和代谢检查结果正常，但在再次经尿道前列腺电切术（Re-TURP）后钙化迅速复发两次。仅通过轻柔刮除钙化避免对残留前列腺组织造成进一步创伤才实现了完全康复。在罕见情况下，TURP后刺激性和梗阻性排尿症状的延迟出现可能由前列腺切除腔的DC引起，可能会被误诊为TURP后感染。DC的发病机制及本病例提示，通过谨慎清除钙化而非进行广泛的Re-TURP来尽量减少组织创伤。
