Detection of Bladder Stone in a Patient Presenting With the Chief Complaint of Rectal Prolapse

Abstract

A 6-year-old girl presented to our hospital with symptoms of rectal prolapse. She reported urinary disturbance over the last few years, which had continued until the time of her visit to our hospital. She reported regular defecation, and a digital examination showed no fecalith or mass. Abdominal X-ray, computed tomography (CT), and magnetic resonance imaging (MRI) revealed a 4.5 cm calcified mass in her bladder; therefore, she was diagnosed as having a bladder stone. An emergency lithotomy was performed owing to uncontrollable pain. Her bladder was opened and the stone was removed. Analysis of the calculus and urinary amino acid analysis revealed the presence of cystinuria. Her rectal prolapse and dysuria disappeared after the treatment. It is rare to encounter a patient having bladder stones and concomitant rectal prolapse. We propose that bladder stones cause dysuria and the elevation of abdominal pressure due to straining. At the same time, bladder stones stimulate pelvic nerves, which cause hyperperistalsis of the bladder, relaxation of anal sphincter muscles, and rectal prolapse. In cases of rectal prolapse without constipation, it is important to determine the cause of dysuria.