Case Report: Giant Vesical Calculus

Abstract

BACKGROUND: Giant bladder calculi are not common in modern urologic practice and many have been found to grow to enormous proportions with minimal symptoms.
METHOD: We report a 1.6 kg stone removed from the urinary bladder of a 48 year old Nigerian man.  The stone increase in size associated with troublesome urinary frequency, which necessitated removal by open vesicolithotomy
RESULTS: The calculus weighed 1.6kg and measured 13cm X 9.5cm X 9.2cm in length breadth and height; and contained calcium carbonate, calcium oxalate, magnesium phosphate and uric acid.  It was a complex stone, sticking to the hypertrophied bladder wall.  A biopsy of the bladder mucosa revealed no malignancy. The patient was on continuous bladder drainage for 10 days and had a urine flow rate of 20mls/sec on discharge. He has been seen in the surgical outpatient department 2 weeks and 4 weeks after discharge with no complaints.
CONCLUSION: Giant vesical calculi are rare and can present with few symptoms.  It is very important to exclude lower urinary tract obstruction as the aetiology though a significant number have no such obstruction. The stones are usually mixed because of associated urinary tract infection.

KEY WORD:  giant, asymptomatic urinary bladder calculus, vesicolithotomy