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Various complications of distal end of the ventriculoperitoneal (VP) shunt have been described in the literature. We present, here, an extremely rare and potentially severe complication of vesical calculi formation on the slit valves of distal end of VP shunt which erosively migrated into the urinary bladder. Suprapubic cystolithotomy performed, peritoneal end of the tube found to be eroding and entering into the bladder with two calculi firmly stuck to slit valves in the distal end of the tubing were removed. Shunt was functional, therefore, it was pulled out and repositioned on the superior aspect of the liver; the urinary bladder was repaired. Patient did well postoperatively. This complication was revealed 1.5 years after the shunt was implanted. Although there were symptoms of dysuria and dribbling of urine of short duration, the patient did not show obvious peritoneal signs; suggesting that, penetration of a VP shunt into the urinary bladder can remain asymptomatic for a long period of time, disclosed late and can lead to considerable morbidity. Careful follow-up is important and management should be individualized.

Two cases of Giant Vesical Calculi were encountered in a semi-urban health facility (Nakowa Hospital, Yauri, Nigeria). careful clinical evaluation and investigation is important in the work up of the patients. surgical technique and accurate diagnosis are essential in their treatment. Nigerian Journal of Surgical Research Vol. 7(1&2) 2005: 203-205

A rare case of vesical calculi complicating the procedure of ventriculo-vesical shunt is presented. In addition to highlighting technical difficulties in placing shunt catheters into the urinary system, the potential complications are discussed. We consider this route of cerebrospinal fluid(CSF) diversion less physiological compared with the peritoneal, pleural or the venous sites, and discourage use of the urinary bladder as the drainage site for the shunting of CSF.

We compare the different methods of treating vesical calculi to establish the most effective and safe modality. Of 128 patients with bladder calculi 5 underwent an open operation, 80 underwent mechanical cysto-lithotripsy and 43 underwent extracorporeal shock wave therapy. Severe complications included hematuria, bladder perforation and mucosal injury in the mechanical cysto-lithotripsy group. We find extracorporeal shock wave therapy to be a simple, effective and safe modality for the management of vesical lithiasis.

Posterior urethral valve and vesical calculus are individually among the most common causes of obstructive lower urinary complaints in children. There are very few reports of association between posterior urethral valves and bladder calculus. We report three such cases. This association of the vesical calculi with posterior urethral valves may lead to a delay in the diagnosis of the posterior urethral valves. The diagnosis of posterior urethral valves should be suspected in all children with vesical or urethral calculi who have persistence of symptoms even after removal of the calculi.

Objects placed in the bladder often become encrusted with stone. Using a technique combining endoscopic visualization and a small open cystotomy, a large encrusted foreign body was successfully and safely removed. The combination of endoscopy and cystotomy is rapid, safe, and potentially applicable for the removal of large vesical calculi.

Although endoscopic lithotripsy of bladder stones has been well described and is widely practiced, comparison of the main modalities of mechanical, electrohydraulic, and ultrasonic lithotripsy is lacking. The exact role of these and other modalities such as the Swiss Lithoclast and extracorporeal shockwave lithotripsy is not clearly defined. The safety and efficacy of the various lithotripsy modalities available to treat bladder calculi were reviewed retrospectively over an 18-year period. A total of 106 patients were treated with some form of intracorporeal lithotripsy. In general, all devices proved to be effective with a low rate of complications. The addition of transurethral resection of the prostate to bladder stone management under the same anesthetic was also found to be a safe procedure for moderate benign prostatic hyperplasia. In summary, transurethral endoscopic lithotripsy is a safe and effective method of bladder stone management both alone and in combination with transurethral prostatectomy. All modalities of intracorporeal lithotripsy are effective; however, devices such as ultrasound lithotripters or the Swiss Lithoclast that utilize larger, rigid probes may be more efficient for patients with large or particularly hard vesical calculi.

We present a case of a bladder stone that had formed around the intravesical portion of tension-free vaginal tape (TVT) material following unnoticed bladder perforation during the procedure. Endoscopic lithotripsy of the bladder calculi was performed and the TVT sling material was removed by an endoscopic approach. High clinical suspicion of bladder complications is necessary when evaluating patients presenting with urinary symptoms after a TVT procedure.

One hundred patients, aged twenty to ninety-two years, underwent 111 procedures for removal of bladder calculi. Most patients (88) had some type of bladder outlet obstruction. Two types of stones were identified: those that had apparently formed in the upper tract and been trapped in the bladder (17 cases) and those that appeared to have formed in the bladder in the presence of various types of outlet obstruction. Stone analysis revealed uric acid stones in 50 percent, calcium oxalate stones in 19 percent, and stones of mixed composition in 31 percent. Five patients had metabolic abnormalities predisposing to stone formation; in 2 cases, these abnormalities were discovered during the evaluation for stone disease. Treatment depended on stone characteristics, associated pathology, and the general health of the patient. A review of the literature with regard to the morbidity and mortality of combining treatment of vesical calculi and bladder outlet obstruction secondary to prostatic obstruction is included.

A technical update on rat kidney transplantation is given. In this study, the bladder-bladder union was made using silk, polyglycolic acid (Dexon), polyglactin (Vicryl), and chromic catgut. The propensity of these sutures to form vesical calculi was investigated in both first and second generation transplants. The results of our study indicate that there is no significant difference (P greater than 0.01) in their calculogenic ability. Special problems attendant with first and second generation kidney transplants are described. The concept and technique of second generation kidney transplants are also described.

Experience of electrohydraulic lithotripsy (URAT I) for bladder stone is presented. The male preponderance among the patients was 91%. The success rate with URAT I was 95%. One patient (1%) died after perforation of the bladder. Stones with diameter 1–3 cm were quickly crushed and evacuated. The operating time was longer for stones smaller than 1 cm. A punch lithotriptor may be preferable for such small concrements. In contrast to some earlier reports, we found that stones larger than 5 cm could be relatively difficult to fragment and evacuate. Cystoscopy one or two months after lithotripsy is advisable in order to evacuate any residual fragments of stone. Such fragments may attach to the mucosa at the operation and consequently be retained at evacuation.

We examined the carcinogenicity of mioga to the urinary bladder of male Fischer-344 rats with vesical calculi induced by dimethyl terephthalate (DMT). Although urinary bladder papilloma and hyperplasia were induced in rats fed on DMT and mioga diet alternately, the carcinogenic activity of mioga was not found.

The theoretical growth morphology of magnesium ammonium phosphate hexahydrate (struvite) crystals which build up about 15% of the renal and vesical calculi is established with the help of the periodic bond chain theory and compared to that of natural and synthetic crystals. The agreement is good; the faces of highest occurrence frequency correspond to the F faces 010, 001, 011, 012, 101, 110 and 111. Habit changes of crystals grown from pure aqueous solutions are shown to depend drastically on growth conditions (supersaturation). The relative development of complementary forms is discussed in relation to the non-centrosymmetry of the crystals.

SUMMARY Three cases of urinary fistula-1 vesico-vaginal and 2 recto-urethral-following vesical calculi have been reported. Conservative management by prolonged drainage in the absence of distal obstruction or infection may suffice to close a small fistula. A large fistula requires surgery for its closure.

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SUMMARY Electronic lithotripsy has been briefly described. Some practical observations on the technique of crushing vesical calculi have been made. Our first 100 cases and results have been discussed. Experimental work in connection with crushing calculi in the upper urinary tract has been described.

In the following account of my humble investigations, I shall confine myself, as much as possible, to the physical phænomena which have fallen under my observa­tion; reserving those of a physiological or pathological character for a sphere more exclusively professional. Although Fourcroy strongly expressed it as his opinion, that calculi would, sooner or later, be dissolved by the introduction of chemical agents into the living bladder; and, although some eminent writers of the present day are of the same opinion; there are others, no less eminent, who entertain doubts as to the adaptation of any direct chemical means to so desirable an end.

We report our institutional experience and review the literature in the management of bladder stones, with particular attention to combined cystolitholapaxy and transurethral prostatectomy. Vesical calculi are associated with obstructing prostatic hypertrophy two thirds of the time. Combined cystolitholapaxy and transurethral resection of the prostate have significant morbidity.