A giant bladder stone: managed with osteotome

Giant bladder stone a rare cause of renal failure, a case report

INTRODUCTION AND IMPORTANCE

Bladder stones constitute approximately 5 % of all urinary tract stones. A giant bladder stone weighing >100 g and a diameter of >4 cm is a rare finding. Bladder stones are more common in adult males. Giant bladder stones are a rare entity in western practice, and are usually associated with bladder outlet obstruction, urinary tract infections, or the presence of intravesical foreign bodies and are rarely associated with renal failure.

CASE PRESENTATION

A 25-year-old Ethiopian male patient presented with facial puffiness of two weeks duration which worsened early in the morning. He had a history of recurrent suprapubic pain, and straining during urination. On examination, he had a tender suprapubic mass. Investigations showed bilateral hydronephrosis and renal failure. Subsequently, the patient was diagnosed with a huge bladder stone with acute renal failure. Later, the stone was surgically removed and the patient was discharged improved.

CLINICAL DISCUSSION

Risk factors for the development of bladder stones consist of bladder outlet obstruction, neurogenic bladder, chronic bacteriuria, presence of intravesical foreign substances, bladder diverticula, and rarely, upper urinary tract stone. Recurrent urinary tract infections, urinary retention, and hematuria are common signs of this disorder and rarely cause a renal failure like our patient.

CONCLUSION

A giant bladder stone is a rare disease in modern urology clinical practice. Despite its rarity, giant bladder stone can cause acute renal failure and needs more attention. A comprehensive clinical assessment and thorough investigation are required during the evaluation of this kind of patient to prevent misdiagnosis and to ensure prompt treatment.

A huge bladder cystine stone

An unusual cystine stone that occur only in patients, who have cystinuria is presented in 24-year-old man. Radiographs showed a giant bladder stone shadow, 8.0 x 10.0 x 5.0 cm in size. The literature was reviewed to identify the giant stones as well as the huge cystine stone which is exceptional yet as.

The vesical calculus

Bladder calculi account for 5% of urinary calculi and usually occur because of foreign bodies, obstruction, or infection. Males with prostate disease or previous prostate surgery and women who undergo anti-incontinence surgery are at higher risk for developing bladder calculi. Patients with SCI with indwelling Foley catheters are at high risk for developing stones. There appears to be a significant association between bladder calculi and the formation of malignant bladder tumors in these patients. Transplant recipients are not at increased risk for developing vesical calculi in the absence of intravesical suture fragments and other foreign bodies. Patients who undergo bladder-augmentation procedures using a vascularized gastric patch appear to be protected from vesicolithiasis, perhaps by the acidic environment. Ileum and colon tissues, however, are colonized by urease-producing organisms, producing an alkaline pH that promotes stone formation. Children remain at high risk for bladder-stone development in endemic areas. Diet, voiding dysfunction, and uncorrected anatomic abnormalities, such as posterior urethral valves and vesicoureteral reflux, predispose them to bladder-calculus formation. Finally, there are a number of techniques and modalities available to remove bladder stones. Relieving obstruction, eliminating infection, meticulous surgical technique, and accurate diagnosis are essential in their treatment.