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A case is described in which a patient, who initially presented with five separate bladder calculi, was found to have had coalescence of three calculi to produce a large stone. This may be one mechanism in the development of a giant vesical calculus.

Augmentation of the bladder by cecocystoplasty has been studied in 37 patients during a 15-year period. The indications for an operation were a small contracted bladder secondary to tuberculosis in 31 cases, interstitial cystitis in 5 and carcinoma of the bladder in 1. Results were studied by the assessment of symptomatic improvement, the effect on renal function, urinary tract infection and the postoperative complications. Urodynamic studies also were done on 23 patients with tuberculosis of the renal tract and the results are discussed. Azotemia was not a contraindication to an operation but patients with enuresis or those who have evidence of psychiatric disturbance should be assessed carefully.