Giant vesical calculus

Giant bladder calculi are not common in modern urologic practice and many have been found to grow to enormous proportions with minimal symptoms.

We report a 1.6 kg stone removed from the urinary bladder of a 48 year old Nigerian man. The stone increase in size associated with troublesome urinary frequency, which necessitated removal by open vesicolithotomy.

The calculus weighed 1.6 kg and measured 3cm x 9.5cm x 9.2cm in length breadth and height; and contained calcium carbonate, calcium oxalate, magnesium phosphate and uric acid. It was a complex stone, sticking to the hypertrophied bladder wall. A biopsy of the bladder mucosa revealed no malignancy. The patient was on continuous bladder drainage for 10 days and had a urine flow rate of 20 mls/sec on discharge. He has been seen in the surgical outpatient department 2 weeks and 4 weeks after discharge with no complaints.

Giant vesical calculi are rare and can present with few symptoms. It is very important to exclude lower urinary tract obstruction as the aetiology though a significant number have no such obstruction. The stones are usually mixed because of associated urinary tract infection.