Gigantic Stones in Orthotopic Neobladder

Introduction-Radical cystoprostatectomy with pelvic lymph node dissection with ileal conduit or orthotopic diversion is the standard treatment of MIBC. These patients are at risk of urolithiasis and treatment is also challenging. We are sharing a case report of gigantic stones in orthotopic neobladder and its surgical management. Case report-A 50 year old gentlemen post operated case of radical cystoprostatectomy with orthotopic diversion 8 years back lost for follow up presented with complains of dull aching suprapubic pain, increased frequency of micturation and occasional hematuria. He was investigated and found to have gigantic stones in his neobladder and was medical stabilised and open pouchlithotomy using infraumbilical incision was done and patient recovered well in postoperative period. Discussion-The incidence of bladder stones in continent U. D is 2.9-12.9% and multiple factors causing it are infection, metabolic factors, anatomical factors, surgical technique and non use of CIC. Patient may be symptomatic or asymtopmatic. Lifetime prophylaxis and follow up is recommended in case of stone formation after urinary diversion. Conclusion-Stone formation is a long term complications in patient with neobladder reconstruction should be closely monitored, require timely prophylaxis and stone causing troublesome require removal either endoscopic or open.