MULTIPLE BLADDER STONES AND SEVERE URETHRAL INJURY IN A PATIENT WITH ACUTE ABDOMEN: A CASE REPORT

Bladder stones are very common in the elderly population with lower urinary tract obstruction, and they are associated with ad-verse outcomes such as recurrent infections and lower urinary tract obstruction. Managing bladder stones has traditionally been done using open procedures such as a cystolithotomy or endo-scopic removal. The objective of the study is to present a rare case of multiple bladder stones in a surgical emergency where urinary diversion was mandatory, as endoscopic manipulation appeared impossible-for an 85-year-old man who presented with acute abdomen symptoms, hemodynamically unstable severe urethral injury, and multiple bladder stones. Abdominopelvic non-contrast computerized tomography (NCCT) showed free fluid in the ab-domen, gas in the bladder, and numerous bladder stones. Emer-gency surgery was performed on the patient, and the preexisting perforated stomach ulcer was surgically reconstructed. For urinary diversion, the decision was made to perform open cystolithotomy to eliminate more than 84 bladder stones of different shapes and sizes. We placed a urinary catheter using a Benique bougie and performed the cystostomy to open a second route.