Pediatric giant bladder stones in an endemic area in Chad, Africa

To describe the epidemiological, clinical, and radiological characteristics of pediatric giant bladder stones in an endemic area in eastern Chad, and to analyze surgical management modalities and postoperative outcomes.

A retrospective, observational, and descriptive study was conducted in a tertiary referral surgical center in eastern Chad from October 2022 to September 2025. All patients under 15 years of age treated for giant bladder stones (diameter ≥5 cm and/or weight ≥100 g) were included. Sociodemographic, clinical, and laboratory and imaging findings were collected and analyzed.

A total of 19 children were included, predominantly male (n = 16; 84.2%), with a mean age of 8.1 years. Most patients (68.4%) were from rural areas with limited access to treated drinking water. The most common presenting symptom was dysuria (73.7%), with 21.1% of children presenting acute urinary retention. Ultrasound revealed a single bladder stone in 86% of patients, with a mean diameter of 5.4 cm. Sixteen percent of children had impaired renal function. All children underwent open cystolithotomy (mean operative time: 47 min). The mean stone weight was 114 g. Postoperative complications were minor, mean hospital stay was 3.6 days, and no recurrence was observed.

Pediatric giant bladder stones in eastern Chad remain a preventable disease mainly affecting boys from rural areas with limited access to safe drinking water and cereal-based diets. Delayed presentation is common and may lead to obstructive urinary symptoms and renal impairment. Ultrasound and plain abdominal radiography are effective diagnostic tools, while open cystolithotomy remains the main treatment option with favorable short-term outcomes. Improving hydration, nutrition, and early access to healthcare is essential to reduce the burden of this condition in endemic regions.