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Huge rare stones in the bladder? Weeping Willow Hospital team NEJM published case

 Last Update: 2022-10-14
 Source: Internet
 Author: User

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The bladder is an organ used to store human urine, and inorganic salts in the urine precipitate to form solid lumps that are insoluble in water and stored in the bladder, forming bladder stones
.
Stones may not be unfamiliar to everyone, but have you ever seen a large stone that looks like a jack?
Recently, a case published in the New England Journal of Medicine told the story of an elderly man who went to the hospital for treatment because of new hematuria, and after examination, the doctor found that the patient's bladder had a large stone that looked like a jack, and after treatment, the patient's symptoms have now been alleviated
.
The first author of the study was Zhao Jiyu, deputy chief physician of the Department of Urology of Beijing Weyangliu Hospital, and co-author was chief physician
Gu Xian'en of the hospital.

Screenshot source: NEJM

The patient, a 70-year-old man, presents for
3 months due to worsening symptoms of the lower urinary tract and new hematuria.

The patient has a history of recurrent urinary tract infections and benign prostatic hyperplasia and has previously refused medical treatment
.
3 months ago, patients began using tamsulosin and finasteride for progressive dysuria, nocturia, urinary frequency, and urgency
.

Post-hospital examination

Physical examination: tenderness on palpation of the suprapubic region, enlargement of the
prostate.
Urinalysis: puruluria, hematuria, bacteriuria
.
Urine culture: Broad-spectrum β-lactamase Escherichia coli
is found.
Kidney and bladder ultrasound: a small nap in the posterior wall of the bladder, with a large echo foci inside, suggests the possibility
of bladder stones.
Abdominal x-ray: shows a large, irregularly shaped, radiopaque stone in the pelvis (Figure A
).

X-rays of the patient's hip and removed stones (Image source: Reference [1])

Diagnosis and treatment

Treatment of infections with ertapenem; Perform a transurethral prostate resection to remove stones of up to 5 cm in size from the bladder (Figure B
).

The stone is uniquely shaped and resembles a toy jack, also known as Jackstone
.
It is usually formed due to a build-up of urine in the bladder and consists of calcium oxalate dihydrate
.

Follow-up after 1 month found that the patient's symptoms were reduced
.

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