Giant urinary tract calculi: A case series

Background:  A giant urinary tract calculus is not common in modern urological practice. The bladder has been known to harbour very large stones, weighing hundreds of grams, some with bearable symptoms, for a long time. These giant stones account for less than 1% of all urinary tract calculi. The aim of the present report is to highlight our management of a series of giant urinary tract calculi. Methods:  A series of 14 patients were seen over 5 years (2004–2009) with giant urinary tract calculi and were studied in detail using their hospital records. Their biodata, clinical presentation, presence of urinary tract obstruction or infection, diagnostic investigations, operative management, and physical and chemical characteristics of the calculi were reviewed. Results:  There were 13 males and one female, and their ages ranged between 4 and 79 years (median 30.5). Ten patients had bladder calculi, one ureteric in combination with a staghorn renal calculus, a second stone in the urethra and two huge staghorn calculi in non-functioning kidneys. The mean weight of the calculi was 153.3 ± 69.6 (range 25–300 g) and the chemical compositions were mainly calcium oxalate, struvite (triple phosphate) and calcium carbonate. All the stones were radio-opaque and two were associated with non-functioning kidneys, and there was no congenital anatomical defect causing obstruction in any of the patients. Conclusion:  Giant urinary tract calculi are most common in the male urinary bladder and are managed by open surgery with very good outcome. There were no anatomical abnormalities causing narrowing in the urinary tract in any of the cases.