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CASE REPORT |
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| Year : 2001 | Volume
: 18
| Issue : 1 | Page : 77-78 |
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Spontaneous extrusion of vesical calculus
SJ Philipraj, K Sasidharan
Division of Urology, Kasturba Medical College, Manipal, Karnataka, India
Correspondence Address:
S J Philipraj
Division of Urology, Kasturba Medical College, Manipal, Karnataka 576119
India
 Source of Support: None, Conflict of Interest: None  | Check |
Keywords: Vesical Calculus; Spontaneous Extrusion
How to cite this article:
Philipraj S J, Sasidharan K. Spontaneous extrusion of vesical calculus. Indian J Urol 2001;18:77-8 |
 Case Report | |  |
A 55-year-old gentleman presented with history of voiding difficulty and recurrent lower abdominal pain of 2 years' duration. He was normotensive and non-diabetic. Rectal examination disclosed no prostatatomegaly. All routine laboratory investigations were unremarkable. He had undergone cystolithotomy 12 years ago elsewhere and remained relatively well till recent illness.
A preliminary evaluation with abdominal ultrasonogram and X-ray KUB disclosed 3 large vesical stones ranging from 5-7 cms and a single opacity in the right iliac fossa with identical characteristic of the bladder stones [Figure - 1]. Intravenous pyelogram and barium enema [Figure - 2] indicated categorically that the stone in the right iliac fossa was outside the vesical and bowel confine.
Cystoscopy disclosed a good capacity generally trabaculated bladder with a relatively pale and smooth right lateral wall. The patient was explored and through a cystotomy, all bladder stones were removed. The migrated stone in the right iliac fossa was retrieved from a fibrotic cavity containing some purulent fluid adjacent and lateral to caecum. All stones had identical physical and chemical characteristics suggestive of vesical origin.
| Comments | | |
Spontaneous extrusion of urinary calculus and subsequent external migration from the site of origin is rare. There are few reports of such extrusion in relation to renal and ureteral stones.[1] However, there is no report till date indicating spontaneous extrusion of vesical calculus.
It is construed that the extravesical extrusion of the stone should have occurred through a focal area in the right lateral wall which was rendered weak through a combination of mural infection and pressure necrosis. The extrusion was presumably insidious since there were no acute symptoms stimulating urinary extravasation or rupture of bladder.
| References | | |
| 1. | Arisawa C, Fujii Y, Higashi Y et al. Hinyokika Kiyo 1995; 41: 209211.  |
[Figure - 1], [Figure - 2]
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