Dystrophic calcification (DC) is an abnormal deposition of calcium salts in soft tissues, usually at sites of prior injury or necrosis. This report presents a previously unreported case of DC within the prostatic fossa following transurethral thulium laser enucleation of the prostate (ThuLEP), leading to prolonged sterile pyuria and urge urinary incontinence (UUI).

-

A 68-year-old Taiwanese male with a five-year history of benign prostatic hyperplasia (BPH) presented with hematuria and urinary frequency persisting for several weeks. Image studies indicated an enlarged prostate and a vesical stone. The patient underwent cystoscopic lithotripsy followed by ThuLEP eight weeks later. Postoperatively, the patient initially reported smooth urination but experienced persistent UUI, urethral discomfort, and intermittent hematuria during defecation. Laboratory tests consistently showed sterile pyuria. Cystoscopy at three months post-ThuLEP revealed numerous stellate and spiculated calcifications on the prostatic fossa and bladder neck. Transurethral removal of these calcifications and underlying prostatic tissue resulted in complete resolution of symptoms.

This case highlights the importance of considering DC in the differential diagnosis of persistent urinary symptoms after prostate surgery. Clinicians should maintain a high index of suspicion, especially in patients presenting with unexplained UUI and sterile pyuria post-enucleation.