Median Lobe Urethral Embolus After Focal Ablation of Gleason 7 Prostate Cancer.

This is the case of a man, aged 56 years, who presented with urinary intermittency, frequency, urgency, and dysuria 5 months after undergoing focal laser ablation (FLA) of Gleason 3+4=7 prostate cancer (PC). Cystoscopy revealed a foreign body obstruction of the bladder and the patient experienced immediate relief after its removal. Final pathology confirmed the diagnosis of the foreign body as a piece of necrotic prostatic tissue originating from the median lobe. To our knowledge, this is the first case of intermittent urethral obstruction by a sloughed median prostatic lobe following FLA. FLA is an emerging therapy for low- or intermediate-grade PCs, and this case highlights the need for continued evaluation of long-term outcomes of this procedure.