Bladder Calculus Complicating Intravesical Foreign Body with Rectovesical Fistula and Fournier’s Gangrene

Abstract

We report a case of a 22-year-old man who presented with suprapubic pain and swelling, intermittent haematuria, acute-on-chronic urinary retention, leakage of urine from the rectum, scrotal gangrene and urosepsis. Abdominal ultrasound scan done showed a large bladder stone formed around a piece of bamboo stick with bilateral hydroureteronephrosis. He was treated by open cystolithotomy, scrotal debridement, suprapubic urinary diversion, scrotal wound dressing and broad-spectrum antibiotics. The chemical analysis stone showed that it was composed of calcium phosphate mixed with calcium oxalate. The rectovesical fistula healed spontaneously after three weeks and the scrotal gangrene healed by secondary intention after six weeks of antibiotics, sitz bath and wound dressing with honey-soaked gauze.