Abstract
Bladder calculi are rare in children; they are typically associated with congenital abnormalities of the bladder, foreign bodies, intestinal mucosa, or infection. There is a high risk of bladder calculi with bladder exstrophy, a rare congenital condition. Primary bladder closure is usually performed in the first days of life, but subsequent bladder calculi are associated with about 15% of bladder exstrophy repairs. We report a case of hair-bearing epithelium serving as a nidus for intravesical stone formation in a 24-year-old male who underwent exstrophy repair as an infant. Our case emphasizes need for close and continued follow-up in patients who receive bladder exstrophy repair as infants. This is the first report in the literature of hair-bearing epithelium serving as the nidus for bladder stones in this unique patient population.
Highlights
Bladder exstrophy occurs at a rate of approximately 1: 10,000 to 1: 50,000 live births
Bladder exstrophy is treated through two main approaches: modern staged repair of exstrophy (MSRE) and complete restoration of exstrophin (CPRE) [1,2]
While there are several reported cases in the literature of iatrogenic bladder calculi due to surgical sutures [7] or hair nidus introduced during clean intermittent catheterization [8], this case is the first reported incidence of a bladder calculus resulting from hair-bearing epithelium in the scar tissue
Summary
Bladder exstrophy occurs at a rate of approximately 1: 10,000 to 1: 50,000 live births. Case report A 24-year-old male with past history of successful bladder exstrophy repair as an infant was referred to our clinic from an outside hospital with recurrent bladder stones throughout adolescence, starting at age 16. He reported the stones appeared linear and “attached to hairs” [Fig. 1]. Was scarred and tortuous from surgery as a child, but patent, and a flexible 16-French cystoscope was able to be passed through the urethra visualize the bladder This revealed a well-demarcated scar consistent with a history of bladder exstrophy repair as well as hairs protruding from the midline scar tissue on the anterior bladder wall [Fig. 3.
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