Publication:

Clinical study and management of vesical calculus

Background Vesical calculus accounts for 5% urolithiasis and is the most common urolithiasis in pediatric age. Although incidence has drastically reduced of late, vesical calculi continue to occupy an important place in everyday urological practice. Hence a study was performed to evaluate the clinical presentation and management of vesical calculus.

Methods A prospective study was conducted in the Department of General Surgery in a tertiary center between December 2012 to May 2014.

Results A total of 42 patients with vesical calculi were studied. Males were more affected than females (6:1). Pain abdomen was the most common presentation (71%). Fifty-two percentage patients were using bore well water to drink. Ultrasonography was the most sensitive investigation. All the cases were treated by surgical modality. Fifty percentage cases were treated with transurethral cystolithotripsy using 80-watt holmium laser. Twenty-one percentage cases underwent Percutaneous cystolithotripsy and the remaining 12 (29%) underwent the open suprapubic cystolithotomy. No complication was noted following percutaneous cystolithotripsy. Most of the vesical calculi were of mixed variety with predominant composition being calcium phosphate, calcium oxalate, and uric acid.

Conclusions Vesical calculus most commonly affects children less than ten years. Most of them present with pain abdomen. Low socio-economic status is more affected. Drinking hard water carries a high risk of vesical calculus. Ultrasonography is the investigation of choice in vesical calculus as it is 100% sensitive.