Bladder stones in women due to intrauterine device migration: a case report

Introduction. Large bladder stones are extremely rare in women, accounting for only 5% of all bladder stones. Therefore, every such clinical case is of scientific interest. Case. The article is devoted to the case with two large bladder stones in a 50-year-old woman, which formed as a result of intrauterine device migration. This patient had complaints of dysuria and the periodic appearance of an insignificant impurity of blood in the urine over the past four years, palpation of dense formations in the projection of the bladder in the suprapubic region. According to laboratory tests, microhematuria and sterile pyuria were revealed, and ultrasound and computed tomography revealed 2 stones 5.5 x 3.9 cm and 4.3 x 3.2 cm in the bladder. Performed transurethral contact combined (pneumatic + laser) cystolithotripsy. Despite their large size, high density, and marked fusion with elements of the intrauterine device, bladder stones were successfully fragmented and completely removed. Discussion. In all published works, an open technique, cystolithotomy, was used to remove such large bladder stones in women. Therefore, the endoscopic approach we used can be considered as a pioneer approach in the treatment of bladder stones of these sizes. Conclusion. The achieved positive effect of the endoscopic approach to surgical treatment indicates the prospect of using minimally invasive techniques for large bladder stones in women.