Doctors removed a bladder stone the size of an ostrich egg from a man who had been having urination problems. How did the man's bladder stone get that large?

Large Bladder Stone

A 64-year-old man from California was taken to the hospital for tests after three days of experiencing pain between his left rib and hip, and having trouble urinating. In the emergency room, doctors performed a CT scan and found that there was a blockage in his left ureter and a very large stone in his bladder.

The stone in the ureter was removed via laser, but the large stone was removed via a neocystolithotomy. Amazingly, the stone removed from his bladder was egg shaped, measured 12 cm by 9.5 cm by 7.5 cm (4.7 by 3.7 by 2.9 inches), and weighed 770 grams. The large stone was found to be composed of 20 percent struvite and 80 percent calcium phosphate.

The man did not have any postoperative complications and has been recovering well. His case is documented in The New England Journal of Medicine.

How Did The Stone Get So Big?

Though bladder stones aren't so uncommon, this particular case was unusually large. As it turns out, the man had a history of undergoing radical cystectomy and orthotopic neobladder construction to treat invasive bladder cancer ten years before this experience.

Although he is in the age range when men are more susceptible to developing bladder stones, his doctors believe that his history with bladder cancer may have contributed to the stones that he developed.

Urinary Retention

Urinary retention is the inability to empty the bladder of urine and may either be acute or chronic. People experiencing acute urinary retention are unable to urinate even if their bladders are full, while those with chronic urinary retention can urinate, they are unable to dispel the urine completely from their bladders.

In the man's case, the sudden onset of urinary retention was caused by the blockage to his ureter, so it's likely that his case was that of acute urinary retention.

Bladder Stones

Bladder stones are hard buildups of minerals that form in the urinary bladder. They may form when urine in the bladder is concentrated or due to foreign objects in the bladder. However, most cases are caused by other problems such as a urinary tract infection (UTI) or a blockage at the base of the bladder.

Although most bladder stones occur in men, they are still less common compared to kidney stones. Symptoms of bladder stones include abdominal pain, blood in the urine, pain or discomfort in the penis, signs of UTI, and urination problems such as frequent urination or only being able to urinate in certain positions.

Though most stones are passed by drinking six to eight glasses of water to increase urination, some larger stones may require open surgery to be removed.