Department of Urology, West Middlesex University Hospital, Chelsea and Westminster Hospital NHS Foundation Trust, London, UK.
Urology, Kidney Stone and Urology Clinic, Bhagalpur, Bihar, India
BMJ Case Rep. 2021 Jan 19;14(1):e234339. doi: 10.1136/bcr-2020-234339.
A 53-year-old man presented with lower urinary tract symptoms and recurrent urinary tract infections since last 3 years without being investigated or treated properly. Examination revealed a hard mobile lump in the pelvis, and blood investigations showed raised serum creatinine of 2.9 mg/dL. Subsequent urgent ultrasound scan showed a large urinary bladder stone with bilateral hydroureteronephrosis, and X-ray kidney, ureter and bladder demonstrated a 9 cm×6 cm elliptical radio-opaque shadow in the pelvis. He underwent emergency admission followed by open cystolithotomy on the next day. He was discharged after 48 hours with a urethral catheter. After 2 weeks, his renal function recovered completely; repeat ultrasound scan revealed complete resolution of hydronephrosis. Urethral catheter was removed following a normal cystogram. Uroflowmetry after 6 weeks revealed underlying bladder outlet obstruction, and he was started on alpha blocker which improved his urinary flow.
一位 53 岁男性，3 年来出现下尿路症状和反复尿路感染，未经适当检查和治疗。检查发现骨盆内有一个坚硬可移动的肿块，血液检查显示血清肌酐升高至 2.9mg/dL。随后的紧急超声扫描显示巨大的膀胱结石伴双侧输尿管积水，X 射线肾、输尿管和膀胱显示骨盆内有一个 9cm×6cm 的椭圆形不透射线阴影。他紧急入院，第二天进行了开放性膀胱切开取石术。48 小时后他带尿道导管出院。2 周后，他的肾功能完全恢复；重复超声扫描显示肾积水完全消退。正常膀胱造影后拔除尿道导管。6 周后的尿流率检查显示存在膀胱出口梗阻，他开始服用α受体阻滞剂，这改善了他的尿流。
