Concurrent Jackstone Calculus and Prostate Cancer: Should They Be Treated Concurrently or Sequentially?

Area of Science:

• Urology
• Men's Health
• Oncology

Background:

• Jackstone calculus is a rare, spiculated urinary stone morphology.
• It's often linked to urinary stasis or bladder outlet obstruction.
• This report details a case co-occurring with significant prostate disease.

Purpose of the Study:

• To present a case of jackstone calculus in a patient with undiagnosed prostate adenocarcinoma.
• To emphasize the importance of comprehensive evaluation in men with lower urinary tract symptoms and elevated PSA.
• To illustrate the feasibility of combined surgical management.

Main Methods:

• A 70-year-old man with dysuria and urinary stream interruption was evaluated.
• Imaging revealed a bladder stone and severe prostatic enlargement.
• Prostate biopsy confirmed adenocarcinoma; patient underwent laparoscopic radical prostatectomy with stone removal.

Main Results:

• A 3.1-cm jackstone calculus was removed along with the prostate.
• Final pathology upgraded prostate cancer to Gleason 3+4=7 (Grade Group 2) with clear margins.
• The patient experienced sustained improvement in lower urinary tract symptoms post-surgery.

Conclusions:

• A distinctive bladder stone may mask or coexist with clinically significant prostate disease.
• Elevated PSA and urinary symptoms warrant thorough investigation, even with bladder outlet obstruction or stones.
• Combined surgical removal of bladder stones and prostatectomy is a viable single-stage approach for selected patients.