Urinary bladder calculus

Case contributed by Dr Hoe Han Guan

Presentation

Recurrent urinary tract infection with poor urine stream

Patient Data

Age: 75 years
Gender: Male
CT

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.

Annotated image

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.

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