Primary urinary bladder calculus


  • A 58 years old man
  • No previous medical illness
  • Presented with recurrent hematuria for few months
  • No associated constitutional symptoms
KUB radiograph

Radiographic findings:

  • There is an oval-shaped opacity at the right hemipelvis measuring about 1.9 x 1.4 cm in size that could represent a urinary bladder calculus.
  • No other obvious opacity along the genitourinary tract.
  • No obvious soft tissue mass.  No bowel dilatation or displacement.
  • Visualized bones and soft tissues appear normal.

Diagnosis: Urinary bladder calculus.


  • Primary bladder calculus is  stone forms de novo in the bladder.
  • Secondary calculus is either stone migrated down from renal or ureteric stone or stone from concretions on foreign body material such as urinary catheter.
  • The most common cause of primary urinary bladder calculus are bladder outlet obtruction, cystocele, neurogenic bladder or foreign body.
  • Radiograph shows densely radiopaque focus, may be single or multiple and often large in size. Lamination is also frequently observed.
  • On ultrasound, calculus is mobile, echogenic with posterior shadowing. Associated bladder wall thickening can be seen due to inflammation.

Progress of patient:

  • Ultrasound of KUB shows prostatomegaly.
  • Patient is treated medically for BPH.
  • Vesicolithotripsy done.
  • KUB radiograph after treatment shows no residual calculus.


Author: radhianahassan