Bladder stone

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at May 18, 2016
StartDiseasesBladder stone

A bladder stone is a hard mass located in the bladder. Sometimes these bladder stones are small enough that a person can naturally pass them, but often they are so large that medical treatment is needed. Most bladder stones occur alongside other medical conditions affecting the urinary tract.

Contents

Definition & Facts

A bladder stone is a mass of many different types of minerals that have crystallized and stuck together into a hard, solid chunk. Bladder stones may vary in texture, shape, and size, and a person may have several stones at once or just suffer from one. These stones often originate as extremely small urinary tract stones in the kidneys before traveling through the urinary tract to the bladder, where they become enlarged. Bladder stones are far more common among men, especially males who are older than 50. If they are not treated, bladder stones can cause infections and other medical complications.

Symptoms & Complaints

It is possible for bladder stones of all sizes to go unnoticed as long as they do not block urine flow or irritate the walls of the bladder. However, even people who do not experience any pain or other unpleasant symptoms may begin to urinate more frequently because their bladder is filled with stones, and frequent urination associated with bladder stones is more common at night.

When the stones start to irritate the lining of the bladder, people may feel pain in their lower abdomen, and urinating can become painful. Men with bladder stones may also feel pain in the penis. Sometimes, the urine of a person with a bladder stone might look bloody, cloudy, or unusually dark. In cases where the flow of urine is being blocked by a large stone, it can be difficult to urinate at all. If a person starts to develop an infection from the bladder stone, they can have a fever and experience lower back pain too.

Causes

The general cause of bladder stones is having a bladder that never empties entirely. This causes urine to become concentrated, and minerals in the urine begin to crystallize. Dehydration may also result in concentrated urine that is full of the minerals that form stones. Compounds that can cause bladder stones include calcium, magnesium, ammonium, uric acid, cystine, and xanthine.

Typically, a bladder that does not empty completely is caused by another medical condition. Bladder stones are so common among men because enlarged prostate glands are the most common cause of stones. An enlarged prostate puts pressure on the bladder and urethra, limiting urine flow.

Another condition that prevents the bladder from emptying is neurogenic bladder, which happens when the nerves that control the bladder are damaged. Anything that causes inflammation or infection in the bladder can also result in a bladder stone. People who have to use a urinary catheter due to a medical condition or surgical procedure frequently develop bladder stones. As previously mentioned, a bladder stone can also be caused by a kidney stone that travels into the bladder.

Diagnosis & Tests

Most people who are diagnosed with a bladder stone are diagnosed after a patient goes to the doctor with complaints of abdominal pain and urination problems. The doctor may physically examine the bladder and prostate to see if they are enlarged, and then a urinalysis will be done. During a urinalysis, a urine sample is examined under a microscope for trace amounts of crystallized minerals or bacteria that cause urinary tract infections.

There are also many different types of imaging tests that can be used to diagnose the presence of bladder stones. An ultrasound or an X-ray of the abdomen may help a doctor to detect stones in the bladder, but smaller stones or stones made from certain materials may not show up in these tests.

To further enhance an X-ray, a patient may have an intravenous pyelogram done. During this test, contrast material is injected into veins that flow through the kidneys and bladder. X-rays can then be done to see if any stones stand out against the contrast material. In addition, a spiral CT scan is an effective way of looking for bladder stones. This test quickly scans the urinary system and shows even the tiniest of bladder stones.

Treatment & Therapy

If a person only has very small stones and no other bladder conditions, they may be able to pass the stone just by drinking a lot of water. However, most bladder stones require medical treatment because the patient is unable to completely empty their bladder and pass the stone. A cystolitholapaxy can be done to remove smaller bladder stones. During this procedure, the patient receives general anesthesia or local anesthesia before a small camera is inserted into the bladder. Once the doctor can see the stones, the doctor will use either a laser, an ultrasound, or a mechanical instrument to manually break the stone up into tiny pieces that are flushed out of the bladder.

Some bladder stones are so large that it would be unsafe or impossible to break them up and flush them out of the bladder. An open cystolithotomy is a surgery that can manually remove a stone from the bladder. This surgery involves creating an incision in the abdomen and bladder, removing the stone, and then stitching up the incisions.

Prevention & Prophylaxis

Bladder stones caused by underlying medical conditions cannot always be prevented, but there are some ways of lowering risks of getting one. Doctors suggest that patients drink plenty of fluids at all times and try to fully empty the bladder while urinating.

One method for making sure the bladder is empty is double voiding, a process whereby the patient urinates once then urinates again after 20 seconds. Sitting down to urinate can also help male patients with enlarged prostates to thoroughly empty the bladder.