Cystolithiasis in maiduguri north eastern nigeria

Background: Vesical calculus is fairly common especially in the arid and semi arid regions of the World especially in the developing countries where is associated with lower socioeconomic status. Majority of vesical calculi occur on a background lower urinary tract obstruction. The study aimed at evaluating the pattern, presentation, and management outcome. Patients and Methods: The study reviewed all patients with bladder calculi between January 2010 to December 2014 in University of Maiduguri Teaching Hospital (UMTH). The diagnosis of vesical calculus was made by clinical evaluation supported by laboratory investigations. Patients with concomitant obstructive uropathy (Benign prostatic enlargement, urethral stricture, and bladder neck stenosis) were thoroughly evaluated and planned for definitive treatment during which bladder stone were extracted. In children open cystolithotomy was combined with definitive treatment for posterior urethral valve, impacted urethral stone, and meatal stenosis. Results: A total of 116 patients were studied age ranged from 18 months to 97 years with male to female ratio of 27: 1. Seventy four, 63.79% were farmers, and 25.86% were children. The peak age groups were children under ten years accounting for 25.86. The presenting clinical features were poor urinary stream, and strangury/pain occurring in 100% of the patients. Others were Hematuria in 32.76%, passage of stone in 15.52%, and improvement in urinary stream with change in posture in 27.59%. Complication at presentation was acute urinary retention (AUR) in 47.41%, and urinary tract infection (UTI) in 19.83%. ` Majority of the stones occurred as a result of obstructive uropathy with prostatic enlargement accounting for 34.48%. The largest stone recorded weighed 1.45kg. The postoperative complications were surgical site infection, and vesicocutaneous fistula in 3.45% each. Conclusions: Vesical calculi are fairly common in the extreme of ages, majority of which are associated with obstructive uropathy making open cystolithotomy a formidable option enabling the surgeon to deal with the obstructing causes at the same sitting.