A rare presentation of alkaptonuria: Extensive prostatic calculi with highlight of stones found in a unique paraprostatic urethral diverticulum

• Published in: International journal of surgery case reports 2017-01, Vol.38, p.192-195
• Main Authors: Masoud, Husam M.F., Alhawari, Hussam H., Alryalat, Nosibah T., Murshidi, Muayyad M., Murshidi, Mujalli M.
• Format: Article
• Language: English
• Subjects: Alkaptonuria; Case Report; Paraprostatic urethral diverticulum; Prostatic calculus; Prostatolithiasis; Transurethral a pneumatic lithotripter
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2017.07.041

•AKU has a very low prevalence. This case sums of the two rarest entities of alkaptonuria and stones in a paraprostatic diverticulum also this case highlights the role endoscopic management of prostatolithiasis in alkaptonuria patient and the role of MRI in diagnosis of para prostatic diverticulum. 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.