Giant Bladder Calculus in an Adult- A Persistent Problem in the Developing World: A Case Report

Introduction: Giant urinary bladder calculus in an adult is an uncommon entity. The number of patients with giant bladder calculi has decreased over recent years owing to wider availability of healthcare and better diagnostic modalities. Case Report: We present a case of a young adult without any history of recurrent urinary tract infections or bladder outlet obstruction with giant vesical calculus who presented to the emergency department with gross hematuria, abdominal pain, and dysuria. Investigations revealed a large calculus in the urinary bladder, and suprapubic cystolithotomy was performed. A large stone of 6.5×6×5.5 centimeters, weighing 125 grams, was removed. On follow-up, the patient was free of any symptoms and cystoscopy was normal. Conclusion: Urinary outflow obstruction must be ruled out in all patients with giant vesical calculus. Patients without any predisposing condition should be treated as a separate entity and evaluated accordingly. Multiple surgical treatment modalities are available for bladder calculus patients. Treatment is personalised as per size of stone, number of stones, and associated comorbidities.

Risk factors for bladder calculus in patients with benign prostatic hyperplasia: a retrospective single-center study

Background: To explore the risk factors that lead to the formation of bladder calculus in patients with benign prostatic hyperplasia (BPH). Methods: Retrospective study was performed between June 2017 and October 2019, 103 patients with BPH who underwent transurethral resection of the prostate (TURP) were included. Patients with BPH were divided into two groups: 32 patients with bladder calculus in group1 and 71 patients without bladder calculus in group2. Characteristics of both groups were compared and univariate and multivariate analyses were performed to investigate the association between BPH with or without bladder calculus. Results: There was no significant difference between the two groups regarding age, duration of BPH, body mass index (BMI), total prostate volume (TPV), total prostate-specific antigen (TPSA), International prostate symptom score (IPSS), serum albumin, hemoglobin, uric acid, urinary tract infection, diabetes, and hypertension. The patients' serum creatinine and acute urinary retention (AUR) were significantly lower, while intravesical prostatic protrusion (IPP) was significantly higher in group 1 than group 2. Multivariate analyses revealed that IPP and AUR were significant risk factors for the formation of bladder calculus in patients with BPH. For IPP, the receiver operating characteristic (ROC) curve showed that the cut-off value of the highest risk of the formation of bladder calculus was 11.5 mm. Conclusions: Our study indicated that IPP and AUR were independent risk factors that were closely linked with the incidence of bladder calculus in BPH patients.