PREPUTIAL SMEGMATIC PENILE CALCULUS IN A 65-YEAR-OLD MALE: A RARE CAUSE OF CHRONIC DYSURIA AND URINARY RETENTION

Abstract

Preputial calculi, also known as smegma stones, are exceedingly rare entities in urolithiasis, typically associated with uncircumcised elderly males suffering from phimosis or poor hygiene. A 65-year-old man with no comorbidities presented with an insidious 8-month history of penile pain during micturition, progressing to urinary difficulty, burning micturition, and complete retention for 2 days. Examination revealed a nodular lesion on the glans, induration, palpable bladder, and bilateral inguinal lymphadenopathy. Ultrasonography–guided FNAC of lymph nodes showed only lymphocytes; intraoperative exploration uncovered a 2 × 1 × 1 cm preputial smegmatic calculus. Surgical excision of the calculus with circumcision ensued. Histopathology revealed chronic non-specific inflammation; malignancy was excluded. Surgical management resulted in rapid symptom resolution. Review of literature highlights pathogenesis, diagnosis, management strategies, and complications, underscoring the need for timely recognition and treatment.