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May 26, 1978

Giant Vesical Calculus

Author Affiliations

From the Department of Urology, Albert Einstein College of Medicine, Bronx, NY.

JAMA. 1978;239(21):2272-2273. doi:10.1001/jama.1978.03280480064024

GIANT vesical calculus weighing 100 g or more is an uncommon urologic entity. A review of the English literature before 1900 revealed reports of 14 cases of giant vesical calculi, and only 15 more have been described since then. This report details the unusual case of a giant vesical calculus, which was composed mainly of uric acid (95%) and less than 5% calcium oxalate monohydrate and rare crystals of sodium acid urate.

Report of a Case  A 72-year-old man was noted by his family physician to have increasing azotemia develop over a one-year period. During this interval, the BUN and serum creatinine levels increased from 37 and 1.5 mg/dl to 110 and 8.0 mg/dl, respectively. Infusion intravenous urogram findings demonstrated a large bladder calculus and poorly functioning kidneys bilaterally (Fig 1). In March 1976, he was referred to us for urologic evaluation. He complained of frequency of urinating day and