Bladder Macrolithiasis Complicating Vesical Neck Stenosis, A Rare Cause of Renal Failure: A Case Report

Abstract

Bladder lithiasis refers to the disease associated with the formation of stones in the bladder. These stones, which can reach several centimetres in size, are formed from aggregates of various mineral and organic substances. Most often these stones are formed as a result of poor bladder evacuation. We report a case of bladder macrolithiasis associated with two stones: right ureteral and renal on bladder neck stenosis revealed by hypogastric pain and signs of lower urinary tract and complicated by renal failure in a 42 year old patient. The physical examination revealed bilateral lumbar tenderness and a hard hypogastric palpable mass. Imaging revealed the presence of a bladder macrolithiasis occluding almost the entire bladder associated with a pelvic ureter stone and a right renal corraliform stone. The treatment consisted of a suprapubic cystotomy with extraction of the macro bladder stone and the ureteral stone delivered through the meatus by ureterolithotomy with cervical incision of the bladder neck. The postoperative course was simple. The evolution was marked by the normalization of the renal function. The patient underwent a lumbotomy for his right kidney stone 2 months later.