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Bladder Stones

Bladder stones, hardened mineral clusters that originate within the bladder, typically arise when urine stagnates for an extended period. The primary symptom often manifests as abdominal discomfort, occasionally accompanied by urinary difficulties. In cases where natural expulsion proves unfeasible, a urologist may intervene to fragment or extract the bladder stone.

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What are bladder stones?

Bladder stones, also known as bladder calculi, are solid masses of minerals that develop within the urinary bladder, the reservoir for urine. Typically, they form when residual urine remains in the bladder after urination.

Smaller bladder stones may go unnoticed and pass through the urine without causing symptoms. However, larger stones can induce intense pain, accompanied by nausea, urinary retention, and potentially bloody urine. If you experience severe pain, urinary difficulties, or worsening symptoms suggestive of bladder stones, seek immediate medical attention at the nearest emergency room.

How common are bladder stones?

Bladder stones occur in approximately 5% of cases where stones develop within the urinary system.

Symptoms and Causes

What are the symptoms of bladder stones?
Bladder stones, depending on their size, can either pass unnoticed or cause significant discomfort. Larger stones can irritate the bladder, leading to intense pain, bleeding, and urinary difficulties. Indications of larger bladder stones may comprise:
 

  1. Changes in urine color: Urine may appear cloudy or dark, and blood may be visible (hematuria).

  2. Frequent urge to urinate: Even after recently urinating, you might feel the need to pee frequently.

  3. Pain: Dysuria, or pain and burning during urination, is common. Additionally, intermittent pain in the lower abdomen, penis, or testicles may occur.

  4. Urinary flow issues: Difficulty initiating urination and maintaining a steady stream, sometimes with interruptions (urinary intermittency).

  5. Urinary tract infections (UTIs): Bladder stones frequently predispose individuals to UTIs, characterized by frequent, painful urination, cloudy and malodorous urine.

    What causes the formation of bladder stones?
    Bladder stones occur when urine stagnates in the bladder for extended periods. Waste products like salt, potassium, and protein waste concentrate and solidify into hard crystals. This typically arises when the bladder cannot fully empty during urination.

    Various factors contribute to the risk of bladder stones:

    1. Bladder Augmentation: Surgical bladder augmentation, using intestinal tissue to enlarge the bladder, may lead to urine retention and stone formation.
    2. Bladder Diverticula: Pockets or cavities in the bladder can trap urine, hindering complete emptying. They can be congenital or develop later due to conditions like an enlarged prostate.
    3. Cystocele: Weakening of ligaments post-childbirth can cause the bladder to descend into the vagina, obstructing urine flow.
    4. Dehydration: Inadequate fluid intake concentrates urine minerals, promoting stone formation.
    5. Enlarged Prostate: Prostate enlargement can obstruct urine flow, making complete bladder emptying difficult.
    6. Kidney Stones: Stones originating in the kidney can migrate to the bladder, potentially growing larger if they become lodged.
    7. Neurogenic Bladder: Nerve damage affecting bladder function can lead to incomplete emptying, necessitating catheterization.
    8. Medical Devices: Prolonged use of bladder-inserted medical devices, like catheters, can promote stone formation due to crystal development on the device's surface.

Who is prone to bladder stones?

Bladder stones can affect anyone, but they are more commonly found in men and individual males at birth who are over the age of 50.

Approximately half of individual males over the age of 50 experience benign prostatic hyperplasia (BPH), a condition where the prostate gland enlarges. The prostate, typically the size of a golf ball, produces some of the fluid in semen during ejaculation. An enlarged prostate can obstruct the complete emptying of the bladder during urination, leading to the formation of stones when urine remains stagnant in the bladder for extended periods.

Additionally, the risk of developing bladder stones increases if you:

- Have nerve damage affecting bladder function, such as from a spinal cord injury.
- Underwent certain types of bladder surgeries, like augmentation cystoplasty.
- Have a kidney stone that cannot pass out of the bladder.

Diagnosis and Tests

How is the diagnosis of bladder stones conducted?

Our Urologist will:

1. Evaluate your medical history.
2. Inquire about your symptoms.
3. Perform a physical examination.


We may also request tests to confirm a diagnosis of bladder stones.

What tests are conducted to diagnose bladder stones? 

To diagnose bladder stones, our Urologist may recommend the following tests:

1. Urine Test (Urinalysis): You will be asked to provide a urine sample, which will be analyzed in a laboratory. Technicians will examine the sample for small bladder stones as well as signs of urinary tract infections (UTIs) or blood.

2. Imaging Tests: Our Urologist may order a computed tomography (CT) scan, X-ray, and/or ultrasound to obtain detailed images of your bladder. These imaging techniques reveal the size, shape, and precise location of bladder stones.

3. Cystoscopy: A cystoscope, a long, flexible, pencil-sized tube with a camera at its tip, is inserted by your provider through your urethra into your bladder. This allows for direct visualization of any stones present in the bladder.

Management and Treatment

How can bladder stones be treated?

Typically, a urologist specializes in the removal of bladder stones. Here are common treatment options:

1. Cystolitholapaxy: This minimally invasive procedure involves inserting a cystoscope into the bladder through the urethra to locate the stone. Then, using either a laser or high-frequency sound waves (ultrasound), the stone is fragmented into smaller pieces. Subsequently, the bladder is flushed with fluids to remove the smaller stone fragments.

2. Surgery: In cases where the bladder stone is particularly large, open surgery may be necessary. The urologist makes a small incision in the abdomen using a scalpel to extract the stone. If the stone is caused by benign prostate hyperplasia, the urologist may also address any prostate tissue that obstructs the urethra during the procedure.

Prevention

Is it possible to prevent bladder stones?

While complete prevention may not be guaranteed, you can take steps to reduce your risk. Hydrating adequately with water is key, as it helps to dilute minerals in urine, making them less likely to aggregate into bladder stones. Consulting our urologist about your daily water intake is advisable.

For individuals over 50 with an enlarged prostate, seeking guidance from a healthcare provider is crucial. They can suggest techniques or medications to facilitate bladder emptying, thus reducing the risk of stone formation.

Additionally, modifying your diet or taking prescribed medications can further decrease the likelihood of developing certain types of bladder stones.

Which foods and beverages should be avoided if one has a bladder stone?

Bladder stone formation can be exacerbated by the consumption of certain foods and drinks high in sodium (salt) and sugars. To minimize the risk of bladder stones, it's advisable to steer clear of:

- Processed foods.
- Fast food.
- Canned soups and vegetables.
- Lunch meats.
- Soda pop.

When is it advisable to consult a doctor?

Reach out to our medical professional if you experience any symptoms of bladder stones. Given that stones can enlarge while within the bladder, seeking treatment promptly upon observing signs is crucial.

A Message from NU Urology and Andrology Clinics

Bladder stones can manifest with mild or absent symptoms or escalate to frustrating or excruciating symptoms such as urinary difficulty and intense pain. Dealing with bathroom issues can be uncomfortable. However, it's prudent to consult our Urologist upon noticing symptoms of bladder stones. Initially small, these stones can grow larger and exacerbate. Our Urologist can also address underlying health issues contributing to bladder stone formation. Effective treatment can mitigate the risk of recurrence.

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