Two-stage transurethral cystolithotripsy of a giant neobladder stone: a case report
- Author:
Sin Woo LEE
1
;
Seung-Kwon CHOI
Author Information
- Publication Type:Case Report
- From:Kosin Medical Journal 2026;41(1):81-84
- CountryRepublic of Korea
- Language:English
- Abstract: Giant neobladder stone (NS) is a rare complication in patients who have undergone orthotopic urinary diversion. Generally, patients with giant NS are treated with open or percutaneous cystolithotripsy to preserve urinary continence. We report the case of a 72-year-old male patient diagnosed with an 11.0-cm giant NS. The patient declined open surgery because of previous postoperative complications. After consultation, transurethral cystolithotripsy (TUCL) was selected as the treatment modality. However, the NS was impacted against the neobladder wall, and because of the hardness of the stone, complete fragmentation was difficult to achieve. Additional treatments were planned with extracorporeal shock wave lithotripsy and a second TUCL. One week after discharge, the patient was readmitted because of pain and hematuria. The second TUCL was performed after conservative management, and surgery required 5 hours to complete. The patient experienced transient urinary incontinence during the first postoperative week, which gradually improved. Both the NS and continence symptoms resolved completely after 3 months of follow-up. The operation time of TUCL for giant NS may be prolonged, and incomplete stone fragmentation can lead to complications, as demonstrated in this case. In our opinion, TUCL should be considered only in selected cases of NS.
