Washington Blair, Hines Brian, Stoneburg Sara
OB/GYN, The Stamford Hospital, 950 Cove Road #7B, Stamford, CT 06902, USA.
Int Urogynecol J Pelvic Floor Dysfunct. 2008 Jan;19(1):157-9. doi: 10.1007/s00192-007-0441-6. Epub 2007 Sep 5.
Multiple large bladder stones resulting in complete procidentia present unique operative challenges. A 71-year-old postmenopausal multipara was admitted to the intensive care unit for urosepsis. A firm irreducible 15 x 10 x 10 cm procidentia was noted on exam with surface erythema, erosions, and edema. A computed tomography scan of the pelvis reported a staghorn calculus in the right renal pelvis and a large calcified fibroid uterus which had prolapsed completely out of the pelvis. After resolution of her urosepsis, the patient was taken to the operating room for a vaginal hysterectomy and surgical correction of her prolapse. A small uterus weighing 67 g was identified with a large bladder mass. Cystotomy revealed multiple bladder calculi, the largest measuring 8.1 x 6.8 x 4.6 cm. Cystolithiasis should be considered when evaluating patients with large calcified prolapse.
多个大膀胱结石导致完全脱垂带来了独特的手术挑战。一名71岁的绝经后经产妇因尿脓毒症入住重症监护病房。检查发现有一个坚硬且无法回纳的15×10×10厘米的脱垂物，表面有红斑、糜烂和水肿。骨盆计算机断层扫描报告显示右肾盂有鹿角形结石以及一个已完全脱垂出骨盆的大钙化子宫肌瘤。在她的尿脓毒症得到缓解后，患者被送往手术室进行阴道子宫切除术及脱垂的手术矫正。发现一个重67克的小子宫以及一个大的膀胱肿物。膀胱切开术显示有多个膀胱结石，最大的结石尺寸为8.1×6.8×4.6厘米。在评估有大钙化脱垂的患者时应考虑膀胱结石症。
