Giant prostatic calculi

Introduction. Large prostatic calculi, which in total occupy almost the entire volume of the prostate gland, are extremely rare. A small number of clinical cases and a variety of treatment methods used in such cases determine the relevance of the study of this problem. Materials and methods. The review is based on articles published throughout history in scientific peer-reviewed journals included in the PubMed database and Elibrary.ru Scientific Electronic Library. The search was performed on the following keywords: «prostatic calculi», «prostate stones», «giant prostatic calculi», «large prostatic calculi», «giant prostatic stones», «large prostatic stones». At the first stage, 115 sources were found, of which 23 articles were included in the review. Results. A total of 20 publications were identified, which included a total of 24 cases of giant prostatic calculi. In 12 (50%) patients of this series of studies, the etiology of calculi was recognized as idiopathic, in 6 (25.0%) - urethral stricture, in 5 (20.8%) - neurogenic bladder, in 1 (4.2%) - eunuchoidism. In 9 (37.5%) patients, prostatic calculi were removed using an open operation: in 6 cases - using transvesical access as in adenomectomy, in 2 cases - using retropubic access as in adenomectomy, in 1 case - using radical nerve-sparing retropubic prostatectomy). In 15 (62.5%) patients, prostatic calculi were removed using endoscopic methods: in 7 cases, transurethral lithotripsy was performed without transurethral resection of the prostate (TURP), in 3 cases - transurethral lithotripsy with preliminary TURP, in 4 cases - TURP followed by extraction of prostatic calculi without crushing them, and in 1 case - in situ lithotripsy by cystotomy. Conclusions. Giant prostatic calculi are extremely rare and mostly secondary. For their removal, both open and endoscopic can be used equally successfully. The small number of works in this area necessitates further research.