Bladder stones, also known as vesical calculus, are crystalized minerals that form in the bladder when urine is not completely emptied. These stones will often pass when they are very are very small in size, but can also get stuck to the walls of the bladder or ureter, gradually collect mineral crystals, and grow in size. As they do, they can cause a patient to have problems with urination, as well as a great deal or pain and discomfort.
Causes and Risk Factors for Bladder Stones
Bladder stones can either form in the kidneys or ureter and travel to the bladder, or form in the bladder itself. In the latter case, stones usually develop when the bladder does not completely empty urine. If urine sits in the bladder for a long enough time, minerals in the urine start to crystalize and develop into bladder stones.
Other possible causes of bladder stones include recurrent inflammation of the urinary tract and a diet high in foods that cause stones (e.g. asparagus, certain leafy vegetables, and offal), as well as not drinking enough water.
Bladder stones are much more common in men than in women. This is because the male urinary tract is longer than the female urinary tract, which means urinary sediment can remain in the urinary tract more easily.
Symptoms of Bladder Stones
Symptoms commonly include:
- Urinary abnormalities, similar to the symptoms of cystitis, such as frequent urination, pain or burning during urination, or the presence of blood in the urine, etc.
- Inability or difficulty urinating, or interrupted urine flow.
- The presence of small, gravel-like stones mixed in with urine.
- Stones may scrape against the wall of the bladder or urethra, causing a urinary tract infection, as a result, patients may develop a fever.
Detection and Diagnosis of Bladder Stones
Doctors can check for bladder stones by conducting a physical examination, as well as checking a patient's medical history. A physical examination may include examining of the lower urinary tract, together with urine tests and abdominal x-rays of the kidneys and bladder – and may also include an ultrasound and cystoscopy.
Treatment of Bladder Stones
Treatment methods for bladder stones are divided into 2 main procedures:
1. Bladder Stone Removal – In the case of very small stones, the doctor may start by having the patient drink plenty of water, so stones can be passed naturally. However, drinking water does not suffice, the removal of stones may be carried out by one of the three following procedures:
- C ystolitholapaxy – A cystoscope is inserted into the urethra to break up the stones into smaller fragments, which can then be removed by the cystoscope.
- Extracorporeal Shock Wave Lithotripsy (ESWL) – This procedure uses sound waves to target kidney stones, causing stones to fragment and break into "stone dust", small enough to pass through urination.
- Surgical Removal – Surgery is required for jackstones (jackstone calculi), stones that have the specific appearance of radiating spicules, or stones that are abnormally large. These kinds of stones are impossible to remove through other methods.
2. Treating the cause of the stones – this is necessary, as removal of the stones without correcting the root cause may result in a recurrence.
For example:
- If the stones are caused by leftover urine in the bladder, the doctor must first determine the cause, and treat both the stones and cause of the leftover urine simultaneously.
- If the stones are caused by a defective bladder function, such as bladder muscles not contracting properly, the patient may require the use of a catheter to help with urination.
Patient Self-Care
- Drink plenty of fluids – especially water; consult the doctor on how much water to drink per day.
- Reduce intake of foods that cause stones.
- In cases of self-catheterization, make sure to strictly follow the instructions of the doctors and nurses.
- Have regular follow-up visits. The doctor may schedule one every 3-6 months.