唐慈翊1,2、陳妤甄1、阮雍順1
高雄醫學大學附設醫院1泌尿科
Tsz-Yi Tang1,2, Yu-Chen Chen1, Yung-Shun Juan1
Department of Urology1, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
Department of Urology2, Kaohsiung Municipal Hsiao-Kang Hospital, Kaohsiung, Taiwan
Introduction: The occurrence of bladder calculi in women is uncommon, and the evaluation of bladder stone in women with neurogenic bladder demands careful attention. We hereby present a case of bladder stones with the pubic hair as the stone nidus in a catheterized female patient.
Case report: A 18-year-old woman had suffered from severe traumatic brain injury and was at vegetative status secondary to a traffic accident since September 2020 and had an indwelling Foley catheter. In 2021, febrile urinary tract infection (UTI) and persistent bacteriuria occurred recurrently. Therefore, urology consultation was obtained for further investigation. Her urine culture showed Proteus mirabilis. Sonography showed no obvious hydronephrosis in the bilateral kidney, but some calcification in the urinary bladder. Laboratory data showed normal renal function. Abdominal CT scan revealed bladder stones (Figure 1) in a thin and elongated shape. Therefore, cystoscopy was performed with showed bladder stones coated on the pubic hair (Figure 2). Cystolithotripsy was then performed. Stone analysis showed a mixture of 70 % struvite stones and 30% calcium phosphate. Her UTI was then subsided.
Conclusion: The role of pubic hair is to provide the matrix for the growth of stones, and it has different components according to different bacteria species and bladder environments. A chronic indwelling catheter may be associated with struvite stones. Regular abdominal radiographs or cystoscopy are recommended in high-suspicious cases.