NEW DELHI: In a very rare case, the doctors at Indian Spinal Injuries Centre (ISIC) have removed at least 16 stones weighing around 500 grams from a paraplegic man’s bladder who came to the hospital for rehabilitation purposes. Deepak (29), a resident of Morena in Madhya Pradesh was undergoing rehabilitation when he was detected with urinary problems. A scan revealed that the bladder had 16 stones of huge size.
He had a spine injury two years ago when he fell from a terrace and sustained a spine injury in the form of compression fracture at D12 spine level and was under treatment at ISIC.“Lower urinary tract infections are common in all paraplegic patients. His bladder was not functioning well, and he had to put a catheter into it. We call it a secondary neurogenic bladder. When I examined him, his bladder had many stones which were silently growing. After an X-ray and other tests, it was revealed the presence of stones in the bladder,” said Dr Prashant Jain, consultant and surgeon at Urology & Andrology department at ISIC.
Dr Jain said that luckily Deepak had no stones in his kidney which was in good shape. “All stones were removed together after which the wound was repaired. The patient is on to complete recovery now,” he said.
“There are two ways of removing stones from a bladder, but it was a small capacity bladder and had an infection as well. So, we decided to remove the stones in one go by an open cystolithotomy procedure,” the doctor added.
Dr Prashant said that during the surgery, the stones were removed through a small hole in the bladder which was made in the suprapubic area. According to Dr Prashant, bladders are more prone to small capacity bladder infections and stones. “The problem is common in most paraplegic patients as their bladder is not naturally working. Bladder works as a storage unit in the body and at the same time as an evacuating organ for the urine,” he said.
“In case of paraplegic patients, they store the urine but do not empty it out. So, the sediment of the urine keeps collecting inside the bladder and with the flow of urine, that sediment keeps churning and ultimately it forms solid stones in the bladder. So, infections and stones become common in such patients,” he said.
Procedure to remove stones at one go
According to Dr Prashant Jain, consultant and surgeon at Urology & Andrology department at ISIC, the surgery to remove the stones was done in one go through a small hole in the bladder which was made in the suprapubic area. All the stones were removed and the patient is recovering now, he said.