Relato de caso: litotripsia endoscópica e cistolitotomia aberta em litíase vesical volumosa

This report describes the case of a 61-year-old male patient diagnosed with large-volume bladder lithiasis, confirmed by abdominal ultrasound after reporting significant periumbilical pain. Initially, endoscopic lithotripsy was attempted, a minimally invasive procedure commonly used to fragment bladder stones. However, due to the considerable size of the stone, the technique was unsuccessful, requiring a reassessment of the therapeutic approach. Given the failure of the initial treatment, open cystolithotomy was chosen, a traditional surgical procedure indicated for cases where lithotripsy is insufficient. The surgery was performed without complications, allowing for complete removal of the stone and providing immediate relief of urinary symptoms. Postoperatively, the patient progressed favorably, with no complications such as infections or urinary retention, demonstrating good clinical recovery. During follow-up, no recurrences or urinary complications were observed, and the patient maintained a good quality of life. This case highlights the need for an individualized approach in the management of large-volume bladder lithiasis, demonstrating that while endoscopic lithotripsy is the first-line choice in most cases, open cystolithotomy remains an effective alternative when minimally invasive procedures fail to achieve the desired results.