Only few cases of jackstones had been reported previously [1, 2]. As the name implies this variety of stone has a characteristic shape resembling a child’s toy. These types of stone are commonly described in the veterinary literature with common occurrence in cattle, cats and dogs. Dogs are mostly commonly affected and are usually composed of silica [3]. Calcium oxalate is the most common component of urinary calculi [4]. Jackstone calculi have a characteristic shape that suggests the specific mineral content of these stones. This can have therapeutic implications. Although this typical shape has been reported with the use of other imaging modalities in human patients and has also been reported on sonograms in various animal species. Dihydrate stones tend to be fragmented by lithotripsy more easily than monohydrate stones. Jackstone calculi in humans are usually specific for calcium oxalate dihydrate stones [5].
Bladder outlet obstruction remains the most common cause of bladder calculi in adults. Most common factors predisposing to bladder stone formation includes prostatic disease, previous lower urinary tract surgery, metabolic abnormalities, intravesical foreign bodies, spinal cord injuries, upper urinary tract calculi [6]. Stones forming due to the above mentioned factors are usually not jackstones. The presentation of vesical calculi varies from completely asymptomatic to symptoms of supra pubic pain, dysuria, hesitancy, intermittency, nocturia, frequency and urinary retention. In our patient the bladder out flow obstruction due to benign prostatic enlargement is the likely cause of this stone. Enlarged prostate probably restricts the calculus into its eccentric location and contributes to the growth of stone by causing stasis of urine.
It is important to recognize the characteristic shape of the jackstones as they are susceptible to lithotripsy. We were able to manage his problems, vesicle stone and bladder out flow obstruction by minimally invasive surgery in single index admission.