1/139. Unusual case of Munchausen's syndrome: factitious vesical lithiasis. We report an uncommon case of a 38-year-old woman who admitted for bladder lithiasis undergoing repeated surgical management and being apparently recurrent. The intravenous pyelography and retrograde urethrocystography clear the urinary tract. Biologic evaluation eliminates any metabolic or endocrine cause. The confirmation of a factitious origin is given by fluorescence X analysis of the extracted stones which conclude to calcium carbonate structure and psychiatric care. The self-intromission of these calculi into the bladder is due to the personality disorder being in the frame of Munchausen's syndrome. Two years later, no recurrence is noted and an excellent psychiatric care is achieved. ( info) |
2/139. An unusual presentation of a foreign body in the urinary bladder: A migrant intrauterine device. A 35-year-old woman, who had had an intrauterine device inserted 7 years earlier, presented with dysuria, pollakiuria, suprapubic pain and urethral irritation. The intrauterine device was found in the bladder with stone formation and was removed by endoscopy. ( info) |
3/139. Percutaneous vesicolithotomy: an alternative to open bladder surgery in patients with an impassable or surgically ablated urethra. PURPOSE: Although vesical calculi are routinely treated transurethrally, open vesicolithotomy is generally performed in patients with an impassable or surgically ablated urethra. We describe a technique of percutaneous vesicolithotomy which we used in patients who had undergone urethral ablation and concomitant continent diversion by appendicovesicostomy. MATERIALS AND methods: Bladder stones were detected in 3 patients with neurogenic bladder who had undergone continent urinary diversion with bladder neck closure and appendicovesicostomy. To treat the stones access to the bladder was achieved percutaneously and the tract was enlarged using a balloon dilator. An Amplatz sheath was slipped over the inflated balloon and after the dilator was removed the sheath provided a working channel through which stones were fragmented and removed using a nephroscope. RESULTS: Each patient was rendered stone-free and discharged home the same day as the procedure. CONCLUSIONS: Percutaneous vesicolithotomy provides an alternative approach for bladder stone removal in patients with an impassable urethra with decreased morbidity compared to open procedures. ( info) |
4/139. Spontaneous expulsion of large vesicle calculi in a woman with paraparesis. INTRODUCTION: urolithiasis is a common but preventable complication of spinal cord Disorders (SCD). CASE REPORT: We report a 25-year-old woman with paraparesis who spontaneously passed two large calculi perurethra without pain and developed urethral scarring. Detrusor hyperreflexia, absence of sensations and lack of sphincter tone could have contributed to painless expulsion of the large calculi in this patient. CONCLUSION: dysuria, a prominent symptom of urolithiasis may not be present in subjects with SCD. awareness about urolithiasis among health professionals involved in the care of SCD patients is necessary for prevention and early intervention. ( info) |
5/139. Prevention of hypertensive crises in patients with high spinal lesions during cystoscopy and lithotripsy. Three patients with high spinal lesions, admitted to the hospital for cystoscopy and lithotripsy, showed signs of severe hypertension due to mass reflex during this operation. This symptom was controlled with an intravenous drip of Arfonade inverted question mark, and the patients felt quite comfortable without any other anaesthesia. Other possibilities for handling such patients are discussed. ( info) |
| urinary tract calculi composed primarily of xanthine are rate both in adults and children. We describe the clinical presentation and management of a 3.5-year-old boy with hereditary xanthinuria (an autosomal recessive disorder of purine metabolism) and primary bladder calculus formed from xanthine. To our knowledge this case demonstrates a previously undescribed form of xanthinuria in childhood. xanthine stones, although rare, should be considered in the diagnosis of urolithiasis. ( info) |
7/139. Intravesical migration of AMS 800 artificial urinary sphincter and stone formation in a patient who underwent radical prostatectomy. A patient who underwent placement of AMS 800 urinary sphincter for incontinence after salvage prostatectomy after radiation therapy failure, experienced urethral erosion of the cuff after 54 months. He was treated with cuff removal and prosthesis deactivation. Thirteen months later, a large bladder stone was removed transvesically, and it contained the reservoir. The remaining sphincter components were also removed. patients with previous radiotherapy are particularly at risk for sphincter erosion, but intravesical displacement of the reservoir is a very uncommon complication. ( info) |
8/139. Giant neobladder calculus. An unusual case of a calculus in the ileal neobladder is presented. The size of the stone is exceptional in the urologic literature (940 g). Neocystolithotomy was performed, with full patient recovery. ( info) |
9/139. Calculus-producing and cytomegalovirus-infected nephrogenic adenoma of the bladder in a prepubertal renal transplant recipient. A 14-year-old prepubertal boy, a renal transplant recipient, was treated for a nephrogenic adenoma. His case is unique in that he is the second youngest renal transplant recipient diagnosed with a nephrogenic adenoma. In addition, the lesion was calculus producing, which has not been previously described, and contained cytomegalovirus inclusions, which has been described only once previously in association with a nephrogenic adenoma in a transplant patient. ( info) |
10/139. Bladder stones around a migrated and missed intrauterine contraceptive device. Bladder stones occasionally develop because of foreign bodies in the bladder. Bladder stones in a 30-year-old woman were found to have formed around an intrauterine contraceptive device that had gone missing many years previously and had migrated into the bladder. Plain abdominal radiograms should be a part of the evaluation in patients with a history of an unretrieved intrauterine contraceptive device. ( info) |