Presentation
Recurrent urinary tract infection with poor urine stream
Patient Data
![](https://prod-images-static.radiopaedia.org/images/59278445/940ca14582edbc2dafb540f2d05d0ce6242ee578e872d93b6d836c344211cffa_thumb.jpeg)
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![This study is a stack](/packs/stack-YQKLCKBI.gif)
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![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/59278671/82ea7fd1df7983eef14fd5609ff0b103bfaa4f1d8d55f0d1327129341b956b39_thumb.jpeg)
![This study is a stack](/packs/stack-YQKLCKBI.gif)
![](https://prod-images-static.radiopaedia.org/images/59278445/940ca14582edbc2dafb540f2d05d0ce6242ee578e872d93b6d836c344211cffa_big_gallery.jpeg)
A large urinary bladder calculus with lamination (like skin of onion). This calculus has occluded both vesico-ureteric orifices resulting bilateral ureteric dilatation and moderate degree of hydronephrosis. Another smaller urinary bladder calculus at the left side. Bilateral perinephric fat streakiness.
No renal or ureteric calculus.
Urinary bladder wall is diffusely thickened.
Prostate gland is markedly enlarged.
![](https://prod-images-static.radiopaedia.org/images/59278723/76bb4cb9b87a280bf1acf3df67c2bbf5e0f0be9504eceef1458e1bd0ec7afb9d_big_gallery.jpeg)
Change to bone window for better assessment of the internal structure of the calculus, the urinary bladder calculus appears to be onion-skin internal lamination.
Case Discussion
Urinary bladder calculi result in bilateral obstructive uropathy. These are likely secondary bladder calculi due to urinary stasis as the result of benign prostatic hyperplasia.