The video article by Teles and Wroclawski[
1], titled “Membranous and prostatic urethra calcification due to
Corynebacterium urealyticum infection,” presents a compelling case study of an 85‐year‐old patient who developed significant calcifications in the membranous and prostatic urethra following a
Corynebacterium urealyticum (
C. urealyticum) infection. This video article is particularly valuable, as it includes relevant endoscopic images that vividly illustrate the calcifications and subsequent endoscopic treatment.
C. urealyticum is a rare, urease‐producing bacterium responsible for 1%–2% of urinary tract infections, often presenting as encrusted cystitis[
2]. The pathogenesis involves the hydrolysis of urea, leading to hyperammonuria and subsequent urine alkalinization. This environment promotes the formation of struvite and calcium phosphate crystals, which can deposit in the urothelium and cause chronic inflammation. Risk factors for infection include prolonged catheter use, immunosuppression, and previous urological procedures.
Postoperative calcifications in the prostate and urethra due to
C. urealyticum can lead to significant morbidity. These calcifications often present as encrusted cystitis or pyelitis and can cause severe urinary symptoms, including dysuria, hematuria, and obstructive voiding patterns[
2]. Diagnosis requires prolonged incubation of urine cultures on enriched media, as standard cultures may miss the pathogen. Treatment typically involves prolonged courses of antibiotics such as vancomycin or teicoplanin, effective against this multidrug‐resistant organism[
3–
6].
1 KEY FINDINGS
1.1 Clinical presentation and diagnosis
The patient, with a history of radiotherapy for prostate cancer and multiple urinary tract interventions, developed dysuria and worsening voiding patterns. Imaging studies, including tomography, revealed extensive calcifications in the membranous and prostatic urethra. This case underscored the importance of considering C. urealyticum as a potential pathogen in patients with complex urological histories and persistent urinary symptoms.
1.2 Endoscopic treatment
The video abstract showcased the endoscopic resection of the calcified tissue, followed by a 6‐week course of antibiotics. Follow‐up transurethral resection demonstrated significant improvement in both local aspects and urinary symptoms. This visual documentation is invaluable for urologists, providing a clear procedural guide for managing similar cases.
2 CONCLUSION
Teles and Wroclawski's[
1] video provides a detailed and visually informative account of managing membranous and prostatic urethra calcifications due to
C. urealyticum infection. The inclusion of endoscopic images and procedural videos makes this article an excellent educational resource for urologists. Given the complexity and rarity of such cases, this video abstract is highly recommended for viewing to better understand the endoscopic management and postoperative care of patients with similar conditions. I encourage readers to watch the accompanying video to gain a comprehensive understanding of the endoscopic treatment and the visual aspects of calcifications associated with this disease.
2024 The Author(s). UroPrecision published by John Wiley & Sons Australia, Ltd on behalf of Higher Education Press.
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