Bladder Stones

Overview

Bladder stones are small, hard stones made of calcium or uric acid that form in the urinary bladder. They often form when urine stagnates (urinary stasis) in the bladder because of poor bladder emptying.

Risk factors for forming bladder stones

  • Men are more likely than women to form bladder stones
  • Elderly
  • Poor fluid intake
  • Incomplete bladder emptying - especially in men with enlarged prostates causing difficulty with passage of urine, or men and women with a condition known as a neurogenic bladder
  • Frequent or recurrent urine infections
  • Other medical conditions causing increased urinary stone formation

Symptoms

Most symptoms are due to irritation of the lining of the bladder by the stones, or when they obstruct the flow of urine out of the bladder. You may have bladder stones and not have any symptoms at all. However, if they are large or if they become lodged in the urethra, they can begin to cause symptoms. Typical symptoms are:

  • Bloody urine
  • Pain with urinating
  • Difficulty passing urine
  • Frequent urinating
  • Frequent urge to urinate
  • Interrupted urine stream
  • Abdominal pain or pressure
  • Abnormally dark or discolored urine
  • Frequent urine infections
  • Leakage of urine with urge (urge incontinence)
  • Inability to pass urine (urinary retention)

Diagnosis

Your doctor may need to order some tests to confirm the diagnosis. These include urine tests (urinalysis, urine culture), blood tests, x-rays, ct scans and ultrasound scans. Your doctor will decide if any additional tests are needed.

Your doctor may decide to perform a cystoscopy to examine the inside of the bladder for the presence of stones, and to assess their size and number. A cystoscopy is a special examination during this which a fiber-optic camera, called a cystoscope, is inserted into the bladder through the urethra.

Minimally invasive treatments for this condition include breaking up the stones with laser, special high energy sound waves (ultrasound) or electrical energy. The fragments are then flushed from the bladder. The minimally invasive approach is performed either through the urethra or through a very small abdominal incision.

If the stones are too large or too numerous to be removed by these methods, open surgical removal may be necessary. Open surgical removal involves making an incision in the abdomen

Prevention

Bladder stones can often recur. Prevention involved drinking plenty of liquids every day, and ensuring that any underlying medical conditions, such as enlarged prostate and neurogenic bladder, are treated appropriately.

Surgical procedures

There are three different surgical methods to treating bladder stones. Two are minimally invasive approaches and the third is traditional open surgery. The advantages of the minimally invasive approaches are: less pain, no incision or a small incision, shorter hospital stay and shorter catheterization times.