“27 Contact Lenses Lost In Woman’s Eye”: 69 Fascinating And Deeply Disturbing Medical Images You Won’t Be Able To Unsee

The patient in this case is an elderly man who has had urinary stasis obstruction for a long time due to benign prostate hyperplasia (BPH).

Due to urinary stasis, numerous stones have formed inside the bladder.

Given the large number of bladder stones and the patient’s symptoms, the management plan involved a multidisciplinary approach, including Transurethral resection of the prostate (TURP): To alleviate bladder outlet obstruction caused by BPH and reduce the risk of recurrent stone formation, an open bladder stone removal, which led to the removal of a mind-blowing number of over 200 stones!

Bladder stones are solid calculi that are primarily found in the urinary bladder. While often calcified, they may also be composed of non-calcific material.

Urinary stasis, such as BPH or neurogenic bladder disorder, is the primary cause. Most such stones are newly formed in the bladder. Some come from the kidneys either as a stone or a sloughed papilla.

Any foreign body left in the bladder that is not spontaneously expelled will eventually form layers of stone material and develop into calculus. In 50% of cases the stone composition is uric acid.

In regards to surgical therapy, endoscopic surgery is used.

Cystolitholapaxy (to break up bladder stones into smaller pieces and remove them), can be achieved by disruptive or ablative therapy, including lasers, pneumatic-powered mechanical contact jackhammer, ultrasound, and direct mechanical crushing with a lithotrite.

Extracorporeal shockwave lithotripsy is also used.

In some cases of extremely large bladder stones or prostates, open suprapubic surgery is done. This allows for the removal of the intact stone, followed by an open prostatectomy (for prostates more than 75 g in size).

The advantage of an open suprapubic cystostomy for bladder stone removal is the reduced surgery time (half the time compared to endoscopic means), easy removal of large or multiple stones, ability to remove stones that might be difficult or hard to fragment with endoscopic treatments and the ability to handle stones that are stuck to the bladder lining.