Giant bladder calculus with no retention of urine.

Benign prostatic hyperplasia often produces chronic and progressive lower urinary tract symptoms or complications such as bladder stone, leading to retention of urine and to seek medical attention. Becharetal1 stated giant urinary bladder stone weighing 100 grams or more are uncommon. In our case 162 grams of bladder stone with few another stones about 10-15 grams in the left lower end of ureter were removed. Available treatment options for vesical calculus include open surgical removal, extracorporeal fragmentation and endoscopic crushing. Recently endo-surgical mechanical cystolithotripsy followed by percutaneous extraction has been in clinical practice for small and moderate sized calculus.

Litiasis vesical gigante / Giant bladder calculus

Las litiasis vesicales de gran tamaño son infrecuentes. Se manifiestan clínicamente por sepsis urinaria a repetición, polaquiuria y estranguria. Se presenta un nuevo caso de litiasis vesical gigante, así como aspectos de su diagnóstico y tratamiento. La paciente de 64 años de edad, asistió a la consulta y refirió padecer de infecciones urinarias reiteradas, incontinencia por urgencia miccional y dolor posmiccional en hipogastrio y uretra. Tenía el antecedente de haber sido operada, siete meses atrás, de un prolapso uterino total por vía vaginal. En el cultivo de orina se aisló Escherichia coli y, en el ultrasonido abdominal, se detectó una litiasis vesical de gran tamaño, la cual se confirmó en la radiografía simple de la pelvis. Se le realizó la cistolitotomía retropúbica, extrayéndose una litiasis de 9 x 6 x 5 cm de tamaño y 186 g de peso. La paciente evolucionó favorablemente con la desaparición total de los síntomas. La litiasis vesical gigante es rara, pero se debe sospechar en pacientes con síntomas urinarios sépticos e irritativos bajos persistentes. El ultrasonido del tracto urinario y la radiografía simple de la pelvis, son suficientes para establecer el diagnóstico de certeza. La cistolitotomía continúa siendo el tratamiento de elección de esta afección.

Giant bladder calculi are uncommon. Their clinical manifestations are recurrent urinary sepsis, polachiuria and strangury. A new case is presented of giant bladder calculus, as well as aspects of its diagnosis and treatment. A 64-year-old female patient attended consultation and stated that she suffered from recurrent urinary infection, urinary urgency incontinence and hypogastric and urethral post-miction pain. Seven months before she had undergone surgery for total uterine prolapse via the vagina. Escherichia coli was isolated from the urine culture, and abdominal ultrasonography revealed a large bladder calculus, which was confirmed by simple pelvic radiography. Retropubic cystolithotomy resulted in the removal of a 9 x 6 x 5 cm, 186 g calculus. The patient evolved favorably with total disappearance of all symptoms. Giant bladder calculus is a rare condition which should be suspected in patients with persistent irritative symptoms of lower urinary sepsis. Urinary-tract ultrasonography and simple pelvic radiography are sufficient to establish the certainty diagnosis. Cystolithotomy continues to be the treatment of choice for this condition.