Multiple preputial stones: A case report and literature review

Preputial Calculus: Unveiling a Rare Encounter and Treatment Journey

Preputial calculus is an infrequent manifestation of urolithiasis, primarily observed in ageing individuals with an uncircumcised penis and not maintaining proper hygiene, which can further be complicated by co-morbidities such as phimosis. On the contrary, phimosis and other neurological/urological malformations have also been reported in children to cause preputial calculus. Overall clinical presentations include a palpable mass within the prepuce, dysuria, hematuria, obstructive uropathy, diminished urine flow, and malodorous discharge. This is a case of a 65-year-old male presented with a complaint of obstructed urinary flow. The patient was diagnosed with obstructive uropathy due to the presence of preputial stone/s. This case illustrates both singular and multiple stones in the affected patient. The patient was managed by surgical intervention by circumcision followed by calculus removal. As per the available published literature, this case can be noted as the first report of the largest preputial stone in an elderly in any rural setup of central India.

Etiology, clinical manifestations, and management methods of cryptitis beside the preputial frenulum in men

BACKGROUND

Inflammatory diseases may occur within the crypt beside the preputial frenulum in men. This study was performed to gain an understanding of the etiology, clinical manifestations, and management methods of cryptitis beside the preputial frenulum in men.

RESULTS

Thirteen patients treated for cryptitis beside the preputial frenulum served as the observation group, and 40 healthy individuals served as the control group. The patients' clinical manifestation was the presence of a yellowish oily substance embedded in the crypt. Wiping off the substance revealed a conical blind cavity-like structure with an opening diameter of 1 to 5 mm (2.8 ± 1.3 mm) and depth of 1 to 4 mm (2.5 ± 1.1 mm). No blind cavity-like structures in the crypt were found in the control group. The shortest distance between the opening edges of the bilateral crypts in the observation and control groups was 6 to 14 mm (10.3 ± 2.4 mm) and 2 to 10 mm (3.9 ± 1.9 mm), respectively, with a statistically significant difference. Examination for pathogens in the secretions from skin lesions showed that the three most common pathogens were Candida albicans, Staphylococcus aureus, and Escherichia coli. All patients recovered after antibiotic treatment.

CONCLUSIONS

A blind cavity-like structure in the crypt may be related to excessive width of the preputial frenulum. Cryptitis may be a secondary infection caused by smegma trapped in the blind cavity-like structure. Maintaining cleanliness in the frenulum area may help to prevent the occurrence of cryptitis. Antibiotic treatment is effective.

Incidental Detection of Preputial Calculus in a Patient with Partial Phimosis: Is it as Rare as We Believed?

Summary. Background:

Preputial stone disease is the rarest type of urolithiasis. Adult males with severe phimosis and poor hygiene are mainly affected.

Case Presentation:

A 90-year-old male sought treatment for steadily worsening urinary frequency, intermittency, incontinence, and pain at the tip of his penis of 3-days duration. Clinical examination revealed a palpable distended urinary bladder, a partial phimosis and a round, hard on palpation, and partly ulcerative lesion at the tip of the foreskin. A single, 1 cm in maximum diameter stone, was incidentally discovered beneath the prepuce and subsequently removed from the preputial sac. The patient refused further treatment with circumcision, and opted for conservative therapy of benign prostate hyperplasia.

Conclusion:

Personal hygiene remains the cornerstone in the prevention of the preputial calculi formation, while circumcision represents the mainstay of treatment for definite stone removal and elimination of the precipitating causes.

Penile skin bridge multiple liathiasis, a diagnosis made in a complication of circumcision in a 24 year old young adult: Case report

Penile skin bridge stones are rare complications which has never been reported in literature hence information about management is non-existent. This case reports a 24-year-old man presenting with recurrent inflammatory symptoms in his sizeable penile skin bridge. Clinical examination revealed multiple calculi which was confirmed after surgical division of the SB. Phimosis and stone migration are the pathological basis underlying all reported cases of non-urethral calculi in uncircumcised elderly phallus. Extra-luminal urolithiasis in a young circumcised man, we believe have different predisposing factors and prognosis. Treatment involved stone removal and debridement of the skin bridge which yielded successful outcome.