Lower tract urolithiasis after prostatectomy.

Nine cases of lower tract urolithiasis after prostatectomy are reported. In addition to these 9 cases 223 from the world literature and 10 from our previous experience also are reviewed. Stones may form after prostatectomy in various locations of the lower urinary tract, including the bladder, bladder diverticulum, prostatic fossa, simultaneously in the bladder and prostatic fossa, and, occasionally, in an iatrogenic pouch. They occur after all forms of prostatectomy, that is surgical or endoscopic, and after benign as well as malignant prostatic lesions. Calculi that form in the bladder most frequently are the result of stasis owing to bladder neck contracture or recurrence of prostatic enlargement. Calculi that form in the prostatic bed (or fossa) are caused by a ligature, infection or a chip of prostate left behind in the prostatic bed. Diagnosis is sometimes difficult because these stones are not always radiopaque and they are not always seen on endoscopy. The interesting theoretical considerations concerning the etiology of these calculi and the measures that could be helpful in their prevention, such as meticulous postoperative care, are discussed.