Retained Bullet in the Prostate Causing Lower Urinary Tract Symptoms

A 41-year-old man presented with a 5-month history of bothersome urinary urgency and frequency. He sustained a gunshot wound to the lower abdomen 15 months prior to presentation. Digital rectal examination revealed a metallic foreign body palpable within the right lobe of the prostate, which was suggestive of a retained bullet fragment within the prostate gland. Cystourethroscopy confirmed a bullet fragment lodged within the right lateral aspect of the prostatic urethra. X-ray of the pelvis illustrated 2 radiopaque foreign bodies projecting at the level of the pubis. The patient deferred surgical retrieval and opted for pharmacological management with anti-cholinergic medication.