# Neglected giant bladder stone with bilateral ureteral stones: A case report of staged surgical treatment

## TL;DR

A 44-year-old man with a giant bladder stone and ureteral stones was successfully treated with staged surgeries, improving his kidney function and symptoms.

## Contribution

This case report highlights a staged surgical approach for managing giant bladder stones and concurrent ureteral stones.

## Key findings

- A 15×10 cm bladder stone and multiple ureteral stones were successfully removed through staged surgeries.
- Post-surgery, the patient's BUN and creatinine levels significantly improved.
- Staged surgical management is effective for complex urological cases with multiple stones.

## Abstract

A giant bladder stone is a rare urological condition in which a massive stone forms due to various contributing factors. We present a rare case of a giant bladder stone with concurrent ureteral stones, detailing its staged surgical management and relevant literature.

A 44-year-old male presented with right flank, left flank, and suprapubic pain for one month prior to admission, accompanied by dysuria and a history of stones passage through the urinary tract. On examination, the patient presented with suprapubic pain, and laboratory results revealed severe anemia with elevated blood urea nitrogen (BUN) and serum creatinine levels. A vesicolithotomy was performed, followed by ureteroscopic lithotripsy (URS) one month later. A 15 × 10 cm bladder stone was found during the first surgery, and multiple ureteral stones were discovered during the second surgery. After surgery, the patient improved BUN (93.5 mg/dL to 27.6 mg/dL), serum creatinine (8.11 mg/dL to 1.85 mg/dL), and reduced flank and suprapubic pain.

The management of giant bladder stones involves open vesicolithotomy, which is considered the gold standard for complete removal, as AUA and EAU guidelines recommend. A subsequent URS for the removal of bilateral ureteral stones provides a favorable outcome for the patient.

A holistic approach for giant bladder stones is required, encompassing diagnosis and surgical planning to minimize misdiagnosis and complications. A staged surgical approach, including vesicolithotomy and ureteroscopic lithotripsy, may be beneficial.

•An adult male presenting with urinary symptoms was diagnosed with a giant bladder stone and bilateral ureteral stones.•Imaging studies revealed multiple stones, including a large bladder stone and several ureteral stones.•The patient underwent staged surgical interventions, successfully addressing the stones and alleviating symptoms.

An adult male presenting with urinary symptoms was diagnosed with a giant bladder stone and bilateral ureteral stones.

Imaging studies revealed multiple stones, including a large bladder stone and several ureteral stones.

The patient underwent staged surgical interventions, successfully addressing the stones and alleviating symptoms.