Urinary Bladder Calculus in an Adult Male Patient Presenting With Obstructive Features: The Radiologic Findings and a Case Report

Urinary lithiasis is a very common urological disease but bladder lithiasis is very uncommon and account for about 5% of urolithiasis and most frequent urolithiasis in pediatric age. It is very important to exclude lower urinary tract obstruction as the cause, but significant cases may come without obstruction. The male sex is more affected than the female sex. This is a case of a 65-year-old male patient with complaint of suprapubic pain, dysuria and increased frequency of micturition for more than two years prior to presentation. Abdominopelvic ultrasound demonstrated a continuous bicovex-shaped echogenicity casting posterior acoustic shadow masking the posterior bladder wall posteriorly in keeping with a bladder calculus. There is associated moderate hydroureteronephrosis with enlargement of the kidneys bilaterally. The plain abdominopelvic radiograph demonstrated a dumb-bell shaped radio-opacity of calcific density in the pelvic cavity in keeping with a bladder calculus The patient had extraperitoneal cystolithotomy with extraction of the entire calculus and got better. We present a case of an obstructive calculus in a 65-year-old male patient without an obvious infravesical urinary obstruction due to its rare nature and peculiar presentation.