Urinary tract stones are a common disease, but concurrent large-size stones in the bladder and urethra are rare. This phenomenon can lead to obstruction, infection, and other complications. We reported the management of a rare case of a giant bladder stone accompanied by a big posterior urethral stone.
A 36-year-old man with a chief complaint of not being able to have spontaneous micturition, frequent expulsion of stones from the penis, and a history of hematuria. Bladder examination revealed a giant bladder stone of 1278 Hounsfield Unit (HU) with a size of 4.1 × 7.2 cm, and urethral examination revealed a stone of 1275 Hounsfield Unit (HU) with a length of 4.3 × 4.2 cm, without mass. This patient underwent vesicolithotomy and urethrotomy. The evaluation showed spontaneous micturition and dissolved hydronephrosis.
Urinary tract stone management primarily involves endourology or open surgery. For smaller stones (<5-6 mm), medication is sufficient, as they often pass spontaneously. Larger stones may require interventions like vesicolithotomy or urethrotomy. Vesicolithotomy is preferred for complex or large bladder stones, while urethrotomy is performed if the stone location is palpable or seen on imaging. These procedures are practical options for general surgeons in first-level hospitals.
Concurrent large bladder and urethral stones are uncommon. Endourology or open surgery is typically employed. Treatment selection should be personalized to individual patient assessment to mitigate potential complications effectively.
International journal of surgery case reports. 2024 Jun 06 [Epub]
Soetojo Wirjopranoto, Yufi Aulia Azmi, Ronald Sugianto, Kevin Muliawan Soetanto
Department of Urology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia. Electronic address: ., Department of Urology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia; Department of Health Sciences, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands. Electronic address: ., Department of Urology, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo General Academic Hospital, Surabaya, Indonesia; Prof. I.G.N.G. Ngoerah General Hospital, Denpasar, Bali, Indonesia., Department of Immunology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.