Vesicocutaneous fistula caused by giant bladder calculus

Area of Science:

• Urology
• Surgical Case Reports

Background:

• Giant bladder calculi are uncommon, and their association with vesicocutaneous fistulas is exceedingly rare.
• This report details a unique presentation of a large bladder stone leading to a complex urinary tract complication.

Observation:

• A 62-year-old female presented with dysuria and a hypogastric wall ulcer from which urine egressed.
• Radiological imaging, including X-ray and computed tomography (CT), confirmed a giant bladder calculus and a resultant vesicocutaneous fistula.

Findings:

• Surgical intervention involved cystolithotomy for calculus removal and fistula closure.
• The removed calculus was massive, measuring 95 x 60 x 55 mm and weighing 350 g.
• This represents the second documented instance globally of a vesicocutaneous fistula attributed to a giant bladder calculus.

Implications:

• Highlights the potential for extreme urological pathology even in the modern era.
• Underscores the importance of timely diagnosis and surgical management for large bladder stones.
• Contributes to the limited literature on giant bladder calculi and associated fistulous complications.