Multiple Giant Stones in an Augmented Bladder: A Case Report.

Area of Science:

• Urology
• Nephrology
• Surgical Case Reports

Background:

• Bladder stones are less common than kidney or ureteral stones.
• Neurogenic bladder disease, often resulting from spina bifida, can predispose patients to urinary tract complications.
• Previous bladder augmentation and continent urinary diversion can alter bladder dynamics and stone formation risk.

Observation:

• A male patient in his 40s with a history of spina bifida and bladder augmentation presented with difficulty in bladder emptying.
• The patient experienced challenges with clean intermittent catheterization.
• Multiple giant bladder stones were identified as the cause of the symptoms.

Findings:

• Six giant bladder stones were surgically removed via open cystolithotomy.
• The stones exhibited unusual geometric shapes, including pyramid and cube forms.
• The largest stone measured a maximum diameter of 7 cm, indicating a significant stone burden.

Implications:

• This case highlights the potential for massive bladder stone formation even after reconstructive surgery.
• The unusual size, weight, and geometric complexity of the stones present a unique clinical scenario.
• Successful surgical intervention demonstrates the feasibility of managing large stone burdens in complex patients.