Adhikari Rojan, Baral Hari Prasad, Bhattarai Utsav, Gautam Ravi Kiran, Kunwar Kiran Jung, Shrestha Dipesh, Katwal Bijay Mansingh
Department of Urology and Kidney Transplant, Shahid Dharmabhakta National Transplant Centre, Bhaktapur, Nepal.
Case Rep Urol. 2022 Aug 27;2022:4835945. doi: 10.1155/2022/4835945. eCollection 2022.
Large urinary bladder stones are not common and even less common in females. We report a case of large bladder stone presented with acute retention of urine in a female patient. . A 62-year-old female presented in emergency department with retention of urine for 12 hours with history of recurrent UTIs for last 1 year. She was also complaining of mild dull lower abdominal pain for last 6 months. She had no history of incontinence of urine and fever. On physical examination, hard mass was palpable on suprapubic region on palpation of abdomen. Urine culture shows Escherichia coli for which antibiotics was given. An X-ray kidney ureter bladder showed a radio-opacity in the pelvic region measuring 9 × 8 cm in size. Ultrasonography revealed bilateral mild hydronephrosis with a large bladder stone. Open cystolithotomy was performed, and the stone was taken out. Stone biochemical analysis showed predominantly urate crystals. Patient had uneventful postoperative course, and she was discharged on 4 postoperative day and was followed up for 1 months after operation.
Large urinary bladder stones are not common and even less common in females. Clinician should have think regarding large bladder stone as a cause of recurrent lower urinary tract symptoms like dysuria and should assess renal function for proper treatment. Open cystolithotomy is choice of operation in large bladder stone.
巨大膀胱结石并不常见，在女性中更为罕见。我们报告一例女性患者因急性尿潴留就诊的巨大膀胱结石病例。一名62岁女性因尿潴留12小时急诊入院，过去1年有反复尿路感染病史。她还诉说近6个月来下腹部有轻度隐痛。她无尿失禁和发热病史。体格检查时，腹部触诊耻骨上区可触及硬块。尿培养显示大肠埃希菌，给予了抗生素治疗。腹部X线平片显示盆腔区域有一不透X线阴影，大小为9×8厘米。超声检查显示双侧轻度肾积水及一枚巨大膀胱结石。行开放性膀胱切开取石术，取出结石。结石生化分析显示主要为尿酸盐结晶。患者术后恢复顺利，术后第4天出院，术后随访1个月。
巨大膀胱结石并不常见，在女性中更为罕见。临床医生应考虑巨大膀胱结石是复发性下尿路症状如排尿困难的病因之一，并应评估肾功能以进行恰当治疗。开放性膀胱切开取石术是治疗巨大膀胱结石的手术选择。
