A 67-year-old man developed dysuria and position-dependent obstructive voiding symptoms after undergoing
holmium laser ablation of the prostate (HOLAP) for benign prostatic hypertrophy. A large fungal (candidal) ball
adherent to the bladder wall was removed by loop excision, but the bezoar recurred in 2 weeks despite systemic ﬂuconazole and intravesical amphotericin B. A second attempt at endoscopic removal with ultrasonic lithotripsy, endoscopic graspers, and fulguration was also unsuccessful. The patient underwent open partial cystectomy to remove his invasive fungal bezoar. Convalescence was unremarkable. Urinalysis, culture, and follow-up cystoscopy after partial cystectomy demonstrated successful deﬁnitive treatment of the fungal ball. UROLOGY 79: e21– e22, 2012. © 2012
Figure 1. Attached fungal bezoar before second transurethral resection.