Clinical Presentation & Protocol
Patient Usually Complains Of
Patient presents with symptoms suggestive of bladder calculus, including intermittent dysuria, suprapubic pain, and terminal hematuria. Reports symptoms of bladder outlet obstruction, including hesitancy, weak urinary stream, and sensation of incomplete bladder emptying. History of recurrent urinary tract infections or previous urological instrumentation noted. No history of fever or flank pain.
Clinical Examination Findings
Abdominal examination reveals a soft, non-tender abdomen. Suprapubic palpation may reveal tenderness or a palpable bladder if significant retention is present. External genitalia examination is unremarkable. Digital rectal examination (DRE) performed to assess prostate size and consistency, noting no suspicious nodules.
Treatment Protocol
Plan includes definitive management via cystolitholapaxy or open cystolithotomy depending on stone size and burden. Pre-operative urine culture to be obtained and antibiotic prophylaxis initiated. Post-operative management includes bladder irrigation, adequate hydration, and analgesia. Metabolic workup to be initiated to prevent recurrence.