骨盆腔器官脫垂造成的巨大膀胱結石：病例報告
郭謹瑋、江恆杰、王百孚
彰化基督教醫院 外科部 泌尿科
Pelvic organ prolapse related giant urinary bladder stone – case report
Kuo-Chin Wei, Heng-Chieh Chiang, Bai-Fu Wang
Divisions of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan
Introduction:
Pelvic organ prolapse will cause many associated discomfort. In some situation, uterine inversion will accompanied with total urinary bladder prolapse. And chronic urine retention will occur. We demonstrate a rare case, who had pelvic organ prolapse for 20 years accompanied with one giant urinary bladder stone due to chronic urine retension.
Case report:
A 82 years old female, who had perineal protruding mass since 20 year ago. The mass was growing over time and became difficult to micturition with painful sensation while sitting. She went to our GYN OPD where pelvic organ prolapse, grade 4 was diagnosed and referred to our OPD due to hard content of urinary bladder. MRI was performed and reveals large vesical stone and bilateral hydronephrosis. Cystolithotripsy was arranged and one huge vesicle stone up to 240 gram was removed.
Discussion:
A vesical calculus in a prolapsed cystocele is rare. And the literature indicated that urinary stasis and infection may be the cause of stone formation. In our case, the pelvic organ prolapse caused the incomplete emptying of urinary bladder leading to the urinary stasis and providing the nidus and infectious environment required for stone development. Impaired renal function was also noted due to chronic urine retention and bilateral hydronephrosis. Vesicolithotripsy is indicated in this kind of patient to protect her renal function and push back the prolapsed organs.
Conclusion:
We present an unusual case that has long-standing pelvic organ prolapse accompanied with chronic urine retention. Huge vesicle stone formation was noted with bilateral ureteral orifice occlusion and impaired renal function.