A rare case of a giant vesical diverticular calculus managed successfully by endoscopy

Abstract

Vesical diverticula occur in the setting of bladder outlet obstruction (BOO) and neurogenic vesicourethral dysfunction. Vesical diverticular calculi are rare, especially for minimally invasive endoscopic lithotripsy treatment. A male patient of around 80 years presented with complaints of urinary intermittency and dribbling for 3 to 4 days. On investigation, the patient was found to have a calculus within a diverticulum in the urinary bladder. After counselling, cystolithotripsy + transurethral resection (CLT+TURP) of the prostate under spinal anaesthesia was performed. Usually, open surgery is recommended for the management of vesical diverticular calculi. However, CLT+TURP was the best option, in this case, keeping in mind the patient’s age and comorbidities. Simultaneous endoscopic resection of the prostate gland would help to treat the cause.