[A case of soft vesical calculi]

Area of Science:

• Urology
• Biochemistry
• Microbiology

Background:

• Soft vesical calculi are uncommon and their composition can vary.
• Understanding calculus composition is crucial for diagnosis and treatment.

Observation:

• A 72-year-old male presented with discharge of a white muddy substance.
• KUB imaging showed vesical calcifications; urinalysis revealed urinary tract infection (UTI) with Proteus mirabilis.
• The patient experienced recurrent discharges of similar calculi.

Findings:

• Infrared spectroscopy indicated calculi composed of calcium phosphate and ammonium hydrogen urate, or magnesium ammonium phosphate.
• Alcian blue-PAS staining revealed acid and neutral glycosaminoglycans and bacterial colonies within the calculi.
• The observed calculi composition differed from established 'matrix calculi'.

Implications:

• This case highlights a unique composition of soft vesical calculi.
• Further research may elucidate the specific formation mechanisms of these calculi.
• This finding could inform differential diagnosis and management strategies for patients with recurrent vesical calculi.