A Giant Vesical Calculus in a Woman with Utero-Vaginal Prolapse: A Rare Case Report

Abstract

Urinary bladder stone is usually defined as a giant calculus when it weighs 100g. The incidence of female urolithiasis is very low. According to literature, fewer than 2% of all bladder calculi occur in female subjects and thus, their presence should provoke careful assessment of the etiology. H. A. is a 70 year old P10+2 2 alive woman from a rural community who presented to the Obstetrics and Gynecology Department of Usmanu Danfodiyo University Teaching Hospital Sokoto with 10 years history of protruding mass through the vagina and pain in passing urine of 1 year duration. No history of haematuria, fever or passage of stones in urine. Vaginal examination show an irreducible third degree uterine decent. Laboratory investigations revealed pus cells in urine and urine culture yielded growth of Escherichia Coli after overnight incubation. The electrolyte, urea and creatinine levels were normal. On ultrasound, a large curvilinear echogenic structure that cast posterior acoustic shadowing consistent with calculus was demonstrated within the urinary bladder. It measured 4.5x3.7cm in size and showed marginal irregularities. The surrounding urine in the bladder show mobile internal echoes. Intravenous urogram showed a dense oval radio opaque calculus in the pelvis measuring about 4.5cm in diameter with normal upper urinary tract. She had open cystolithotomy with total abdominal hysterectomy. The stone weighs 142g.