An 8-year-old FS DSH was presented for evaluation of chronic hematuria and more recently dribbling of urine. Additional history was a spinal osteosarcoma that had been removed two years ago with residual weakness of the right hind as the only complication.
Severe bladder calculi and urethral calculi.
Renal calculi, non obstructive.
The urinary bladder in this patient revealed a large amount of calculi and the wall was embedded with multiple calculi and sand. This continued into the pelvic urethra. The kidneys revealed largely normal size and structure; corticomedullary definition and ratio (cortex 1/3 of medulla) were essentially maintained with some age related loss of curvilinear patterns. The cortices presented largely uniform texture with some age related echogenic changes that are not likely of clinical significance at this time unless inflammatory sediment or proteinuria is present. Medullary echogenicity differed distinctly from that of the cortex and no evidence or dilation could be seen. The capsules were acceptably uniform for this age patient without dramatic irregularities. Minor amount of mineralization was noted. No obstructive disease was noted at this time. The right kidney measured 4.16 cm. The left kidney measured 4.08 cm.
Renal calculi, non obstructive. Cystotomy with normal and retrograde flushing of the urethra is recommended in this patient with stone analysis and culture.
Bladder – interstitial cystitis, urolith, neoplasia, bacterial cystitis, neurogenic bladder, polyploid cystitis, granulomatous cystitis
Urethra – lith, neoplasia
Kidney – pyelonephritis, renolith, neoplasia
