A rare case of urachovesical calculus: a diagnostic dilemma and endo-laparoscopic management.
Urachal anomaly in an adult is extremely rare, as the majority of urachal remnants obliterate shortly after birth. A 55-year-old man presented with irritative voiding symptoms. A plain film demonstrated a radiopaque shadow in the region of the urinary bladder. Ultrasonography showed a fixed echogenic focus in relation to the anterior bladder wall. With these investigations, the patient was referred to us with a diagnosis of a vesical stone. We suspected it to be a case of a urachal calculus. Therefore, a CT scan of the pelvis was obtained, which showed a midline tubular tract containing a cylindrical stone, further extending into the bladder as a pedunculated stone. The patient was managed by a combination of endoscopic and laparoscopic techniques. A urachovesical stone like a cherry (pedunculated) has not been reported previously in the English-language literature. This case also illustrates for the first time the combined use of endoscopy and laparoscopy to retrieve a urachovesical stone and the excision of the urachus.
Ansari
M S
MS
Department of Urology, All India Institute of Medical Sciences, New Delhi. akhemal@hotmail.com
Hemal
A K
AK
D002137:Calculi / Q000175:diagnosis* / Q000601:surgery*; D003937:Diagnosis, Differential; D004724:Endoscopy; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D014497:Urachus / Q000002:abnormalities*; D001744:Urinary Bladder Calculi / Q000175:diagnosis*