Bladder calculi

Case contributed by Ashesh Ishwarlal Ranchod
Diagnosis certain

Presentation

Urgency, slow urinary stream, and incomplete bladder emptying (LUTS).

Patient Data

Age: 70 years
Gender: Male
x-ray
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Info

The urinary bladder has multiple, circumscribed, uniform, dense calculi. The bony pelvis is unremarkable.

ultrasound
This study is a stack
Transverse
This study is a stack
Transverse
Transverse
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Info

Extensive, mobile, dependent, urinary bladder calculi with typical posterior acoustic shadowing. There is trabeculation and absent diverticulation. There is significant residual bladder volume post micturition, with bilateral hydronephrosis and hydroureter. The prostate is not identified.

Case Discussion

Features suggestive of extensive secondary urinary bladder calculi. There is a history of chronic urinary retention (LUTS); hence, urinary stasis was the likely cause. The prostate could not be identified due to the extensive calculus burden and associated posterior acoustic shadowing, well demonstrated in the video clip. On this bases, prostatomegaly was not excluded. There was smooth trabeculation, absent diverticulation and a significant residual urinary bladder volume post-micturition. A formal urological assessment with a view to further imaging (VCUG/ CT/MRI) and workup was advised. The patient however presented to an external facility for further management.

Case courtesy of Dr M.N. Patel

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