Molla Yohannis Derbew, Getahun Gashaw Messele, Assefa Mezgebu Alemneh
Department of Surgery, University of Gondar, Collage of Medicine and Health Sciences, Gondar, Ethiopia.
Department of Surgery, University of Gondar, Collage of Medicine and Health Sciences, Gondar, Ethiopia.
Int J Surg Case Rep. 2023 Apr;105:108085. doi: 10.1016/j.ijscr.2023.108085. Epub 2023 Mar 29.
Bladder stones constitute approximately 5 % of all urinary tract stones. A giant bladder stone weighing >100 g and a diameter of >4 cm is a rare finding. Bladder stones are more common in adult males. Giant bladder stones are a rare entity in western practice, and are usually associated with bladder outlet obstruction, urinary tract infections, or the presence of intravesical foreign bodies and are rarely associated with renal failure.
A 25-year-old Ethiopian male patient presented with facial puffiness of two weeks duration which worsened early in the morning. He had a history of recurrent suprapubic pain, and straining during urination. On examination, he had a tender suprapubic mass. Investigations showed bilateral hydronephrosis and renal failure. Subsequently, the patient was diagnosed with a huge bladder stone with acute renal failure. Later, the stone was surgically removed and the patient was discharged improved.
Risk factors for the development of bladder stones consist of bladder outlet obstruction, neurogenic bladder, chronic bacteriuria, presence of intravesical foreign substances, bladder diverticula, and rarely, upper urinary tract stone. Recurrent urinary tract infections, urinary retention, and hematuria are common signs of this disorder and rarely cause a renal failure like our patient.
A giant bladder stone is a rare disease in modern urology clinical practice. Despite its rarity, giant bladder stone can cause acute renal failure and needs more attention. A comprehensive clinical assessment and thorough investigation are required during the evaluation of this kind of patient to prevent misdiagnosis and to ensure prompt treatment.
膀胱结石约占所有尿路结石的5%。重量>100克且直径>4厘米的巨大膀胱结石是罕见发现。膀胱结石在成年男性中更为常见。巨大膀胱结石在西方临床实践中是一种罕见病症，通常与膀胱出口梗阻、尿路感染或膀胱内异物有关，很少与肾衰竭相关。
一名25岁的埃塞俄比亚男性患者出现持续两周的面部浮肿，晨起时加重。他有耻骨上区反复疼痛及排尿费力的病史。检查时，耻骨上区有压痛性肿块。检查显示双侧肾积水及肾衰竭。随后，该患者被诊断为巨大膀胱结石伴急性肾衰竭。之后，结石被手术取出，患者出院时病情好转。
膀胱结石形成的危险因素包括膀胱出口梗阻、神经源性膀胱、慢性菌尿、膀胱内异物存在、膀胱憩室，以及罕见的上尿路结石。反复尿路感染、尿潴留和血尿是该疾病的常见症状，很少像我们的患者那样导致肾衰竭。
巨大膀胱结石在现代泌尿外科临床实践中是一种罕见疾病。尽管罕见，但巨大膀胱结石可导致急性肾衰竭，需要更多关注。在评估此类患者时，需要进行全面的临床评估和彻底的检查，以防止误诊并确保及时治疗。
