Bladder calculi presenting as complete procidentia.
Multiple large bladder stones resulting in complete procidentia present unique operative challenges. A 71-year-old postmenopausal multipara was admitted to the intensive care unit for urosepsis. A firm irreducible 15 x 10 x 10 cm procidentia was noted on exam with surface erythema, erosions, and edema. A computed tomography scan of the pelvis reported a staghorn calculus in the right renal pelvis and a large calcified fibroid uterus which had prolapsed completely out of the pelvis. After resolution of her urosepsis, the patient was taken to the operating room for a vaginal hysterectomy and surgical correction of her prolapse. A small uterus weighing 67 g was identified with a large bladder mass. Cystotomy revealed multiple bladder calculi, the largest measuring 8.1 x 6.8 x 4.6 cm. Cystolithiasis should be considered when evaluating patients with large calcified prolapse.
Washington
Blair
B
OB/GYN, The Stamford Hospital, 950 Cove Road #7B, Stamford, CT 06902, USA. bwashington@stamhealth.org
Hines
Brian
B
Stoneburg
Sara
S
D000368:Aged; D052858:Cystocele / Q000209:etiology*; D053715:Cystotomy / Q000379:methods; D005260:Female; D006801:Humans; D007045:Hysterectomy, Vaginal; D001744:Urinary Bladder Calculi / Q000150:complications* / Q000175:diagnosis*; D014596:Uterine Prolapse / Q000209:etiology*