A Bladder Stone Resulting from the Urachal Remnant: A Rare Case

Introduction: The urachus closes naturally after birth. Its opening leads to anomalies in which secondary complications may be formed, including urachus calculi. This disease is often discovered incidentally in radiographic examinations and is rare in adults. The purpose of this study is to present a rare case of urachus calculus in an adult, which is located precisely in the anterior wall of the bladder, and the insertion of the bladder into the urachus.Case presentation: The patient was a ۳۸-year-old man referred to a urologist with complaints of abdominal ambiguous pain. He had tenderness over the abdomen wall on physical exam. Vital signs and laboratory results were normal. He had no weight loss, symptoms of urinary obstruction and irritation, hematuria, and past medical history. A CT scan of the abdomen and pelvis was requested for the patient. The CT scan images showed a calculus attached to the anterior and inner wall of the bladder, in the insertion of the bladder to the urachus (Fig.۱). Cystoscopy showed calculus is connected to the urachus duct without any mass/tumor (Fig.۲). The collection of evidence suggests calcified urachus. The patient was discharged with conservative treatment and a mild analgesic.Conclusions: Physicians and specialists should notice that the urachus stone is not mistaken for a bladder stone, though rare. Urachus stones require conservative treatments and the patient must be periodically followed up to ensure symptoms or complications do not occur.

Keywords:

Urachal Remnant , Calculus , Bladder , Stone Bladder