Giant bladder stones (>100g) are rare in modern practice but remain a significant challenge in resource-limited settings. We present a remarkable case of a 250g vesical calculus causing severe bilateral hydronephrosis. A 63-year-old male presented with 3-year history of LUTS and recent AKI (creatinine 1.9 mg/dL). CT revealed an 8.2×4.9×3.6 cm bladder stone with bilateral hydronephrosis. Notably, the patient had chronically inadequate fluid intake (<1L/day) without risk factors. Open cystolithotomy successfully extracted the 250g stone (8.5×5×4 cm), with complete postoperative recovery.
International Journal of Case Reports in Surgery
