DOI: 10.12890/2026_007277
Giant bladder calculus presenting as a rare cause of renal impairment in a young adult with substance use disorder
Authors
echaratsi@gmail.com
Keywords
Bladder stones, substance use disorder, urinary retention, chronic kidney failureAbstract
Background: Giant vesical calculi, defined as stones larger than 40 mm and weighing over 100 grams, are uncommon in young patients. In developed countries, only a limited number of case reports have been published, and no previous cases have been reported in patients with substance use disorder.
Case report: The rare case of a young male presenting with a giant bladder calculus causing obstructive nephropathy and renal impairment is reported. The patient had a history of substance use disorder, mainly opioids, and suffered from chronic urinary retention. Clinical and biochemical recovery was achieved after open cystolithotomy and antibiotic treatment for concomitant urinary infection.
Conclusion: Vesical lithiasis can occur in young individuals with chronic substance abuse due to urinary stasis. Opioids have been implicated in the development of chronic urinary retention. In severe cases, the progressive formation of giant stones can be complicated by chronic renal impairment, obstructive hydronephrosis and urinary tract infections. Surgical management with open cystolithotomy remains the gold standard treatment when not contraindicated.
References
- Chakit M, Aqira A, Mesfioui A. A case report of a giant bladder stone (12 × 8 cm, 610 g). Radiol Case Rep 2023;19:970-973. doi: 10.1016/j.radcr.2023.11.081
- Franco-González CD, Martin-Millet JA, González-Guillermo CA, Méndez-Atoche M, Caballero-Osorno P, Flores-Tapia JP. A Case Report and Literature Review of a Giant Bladder Stone in a 43-year-old Female (9 x 8 x 4 cm, 250g). Radiol Case Rep 2024;19:5539-5543. doi: 10.1016/j.radcr.2024.08.019
- Pannu AS, Pannu BS. A rare case of a 2-pound urinary bladder stone in a 32-year-Old male. Urol Case Rep 2025;61:103054. doi: 10.1016/j.eucr.2025.103054
- Acharya GB, Baral S, Bijukchhe SM, Mishra S, Bhusal K, Poudel S. Giant urinary bladder stone: A rare case report. Int J Surg Case Rep 2024;122:110174. doi: 10.1016/j.ijscr.2024.110174
- Darwesh S, Chipongo H. An unusual cause of recurrent urinary tract infection in a male patient and diagnostic challenge: a case report. Int J Surg Case Rep 2025;133:111543. doi: 10.1016/j.ijscr.2025.111543
- Wani M, Hamdoon M, Dewar G, Buakuma P, Madaan S. Urological Implications Associated with the Use of Recreational Drugs: A Narrative Review. Turk J Urol 2022;48:254-261. doi: 10.5152/tud.2022.22066
- Mallappallil M, Sabu J, Friedman EA, Salifu M. What Do We Know about Opioids and the Kidney? Int J Mol Sci 2017;18:223. doi: 10.3390/ijms18010223
- Hadji M, Rashidian H, Marzban M, Naghibzadeh-Tahami A, Gholipour M, Mohebbi E, et al. Opium use and risk of bladder cancer: a multi-centre case-referent study in Iran. Int J Epidemiol 2022;51:830-838. doi: 10.1093/ije/dyac031
- Chau DL, Walker V, Pai L, Cho LM. Opiates and elderly: use and side effects. Clin Interv Aging 2008;3:273-8. doi: 10.2147/cia.s1847
- Dray A, Metsch R. Opioid receptor subtypes involved in the central inhibition of urinary bladder motility. Eur J Pharmacol 1984;104:47-53. doi: 10.1016/0014-2999(84)90367-4