Year : 2001 | Volume
: 18 | Issue : 1 | Page : 77--78
Spontaneous extrusion of vesical calculus
SJ Philipraj, K Sasidharan
Division of Urology, Kasturba Medical College, Manipal, Karnataka, India
S J Philipraj
Division of Urology, Kasturba Medical College, Manipal, Karnataka 576119
|How to cite this article:|
Philipraj S J, Sasidharan K. Spontaneous extrusion of vesical calculus.Indian J Urol 2001;18:77-78
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Philipraj S J, Sasidharan K. Spontaneous extrusion of vesical calculus. Indian J Urol [serial online] 2001 [cited 2021 Apr 21 ];18:77-78
Available from: https://www.indianjurol.com/text.asp?2001/18/1/77/37459
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.
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. 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.
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