What the study found
A 78-year-old man developed two very large stones in an ileal neobladder after 18 years without urological follow-up. The stones were removed successfully with open cystolithotomy, and his symptoms resolved.
Why the authors say this matters
The authors conclude that lifelong structured follow-up is necessary for patients with urinary diversion, because long gaps in surveillance and missed preventive care can allow severe stone formation. They also state that open cystolithotomy remains the treatment of choice for giant neobladder stones.
What the researchers tested
This is a case report of a patient who had radical cystoprostatectomy and ileal neobladder reconstruction for muscle-invasive bladder cancer in 2006. The report describes his presentation, computed tomography findings, stone analysis, surgery, and follow-up over 12 months.
What worked and what didn't
Computed tomography showed two stones measuring 10×8×6 cm and 9×7×8 cm, with a combined weight of 950 grams. Open cystolithotomy removed both stones in 90 minutes with minimal blood loss and no complications; stone analysis showed pure struvite-carbonate apatite linked to chronic Proteus mirabilis infection. The patient was stone-free on imaging and had stable renal function during follow-up, but he was later lost to follow-up again.
What to keep in mind
This report describes a single patient, so it cannot estimate how often this happens or compare treatments. The abstract does not describe additional limitations beyond the case's long surveillance gap and the patient's later loss to follow-up.
Key points
- Two giant stones formed in an ileal neobladder after 18 years without urological follow-up.
- The stones weighed 950 grams combined and were removed by open cystolithotomy.
- Stone analysis showed pure struvite-carbonate apatite, associated with chronic Proteus mirabilis infection.
- The patient had symptom resolution, stone-free imaging, and stable renal function during 12 months of follow-up.
- The authors emphasize lifelong structured follow-up and preventive measures for urinary diversion patients.
Disclosure
- Research title:
- Dual giant neobladder stones after long follow-up loss
- Authors:
- Youssef Maachi, Amine EL Boustani, Amine Salim Lalaoui, Amine Slaoui, Tarik Karmouni, Abdellatif Koutani, Khalid Elkhader
- Institutions:
- Mohammed V University
- Publication date:
- 2026-04-02
- OpenAlex record:
- View
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