What one woman thought was a UTI ended up being a bladder stone so large, she needed to have surgery to remove it.
A case report published in the journal Oxford Medical Case Reports shares the case of an unnamed 56-year-old woman from Chicago, Illinois, who went to the emergency room after experiencing abdominal pain and pain while urinating for three days.
She told doctors that she had been experiencing minor abdominal pain for the past six months and when she initially sought treatment, she was diagnosed with a UTI and given antibiotics. But her pain persisted after the treatment, and eventually, it became so intense and occurred with urination—symptoms that ultimately sent her to the ER for further help.
Upon inspection, the ER medics found a firm mass in her abdomen, which prompted doctors to perform a CT scan. They found that the “mobile, subumbilical” mass was actually a massive bladder stone, measuring 11 centimeters in diameter (about four inches).
Doctors were able to successfully remove the bladder stone, and the woman did not suffer from any other complications. But a case like this is extremely rare: Only around 5% of bladder stone cases occur in women, and even fewer are as large as the bladder stone in this incident.
“To our knowledge, there are only a few cases of giant bladder stones presenting with complications of kidney injury,” the case report states. “Due to the relative rarity of giant bladder stones, there is not enough data on the incidence, management and long-term follow-up on this entity; however, an early diagnosis and surgical management are needed to prevent permanent kidney injury, ensure appropriate evaluation for underlying risk factors, as well as optimize surveillance for recurring stones.”
Bladder stones occur when minerals in leftover urine in the bladder stick together and begin to crystalize, creating a “stone” which settles in the bladder. Bladder stones can either develop in the bladder itself or can start as kidney stones, which, left untreated, can flow into the bladder and turn into a bladder stone.
"As this urine sits there, it provides time and a location for the chemicals in the urine to form stones," Brian Helfand, MD, a urologist at NorthShore University HealthSystem in Chicago, Illinois, tells Health. "Bladder stones more commonly occur in men. This is because men tend to be more susceptible to incomplete bladder emptying because of obstructing prostate tissue. Women can also have pelvic organ prolapsed that prevents complete bladder emptying. This can also predispose to stones."
If the stone irritates the bladder lining or falls into the wrong place, it can prevent urine from passing and be very painful. Some symptoms of bladder stones include severe abdominal pain, difficulty draining urine, or blood in the urine.
"If bladder stones are recognized when they are small, then they usually can pass on their own," says Dr. Helfand. "Therefore, increasing fluid intake in these patients usually helps pass these stones on a timely basis. However, if the stones are large then the stones often require a minimally invasive way to remove the stones."
Dr. Helfand explained that if the stone isn't too large, a laser fiber can help break the stone into fragments which can then be flushed out in the urine. If it is large, like the woman's in this case study, a incision has to be made to the bladder and doctors will remove the stone surgically.
Bladder stones can generally be prevented by drinking plenty of water and keeping a healthy lifestyle with diet and exercise, says Dr. Helfand. As for the woman who sufferent from the giant bladder stone, according to the case report, she had a complete recovery and no further complications from the surgery.
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