Bladder stones

Definition

Bladder stones are hard buildups of mineral that form in the urinary bladder.

Causes, incidence, and risk factors

Bladder stones are usually the result of another urologic problem such as urinary tract infection, bladder diverticulum, neurogenic bladder, or an enlarged prostate. Approximately 95% of all bladder stones occur in men. Stones originating in the bladder are much less common than kidney stones.

Bladder stones may occur when urine in the bladder is concentrated and materials crystallize. The patient feels symptoms when the lining of the bladder is irritated by the stone or when the stone obstructs the flow of urine from the bladder.

Symptoms

• Frequent urge to urinate
• Interruption of the urine stream
• Difficulty urinating
• Inability to urinate except in certain positions
• Blood in the urine
• Abdominal pain, pressure
• Pain, discomfort in the penis
• Abnormally colored or dark-colored urine
• Urinary tract infection
  • Dysuria (painful urination)
  • Urinary urgency
  • Fever

Incontinence may also be associated with bladder stones.

Signs and tests

• Physical examination, including rectal examination, may reveal enlarged prostate or other urologic conditions.
• Urinalysis may show blood or may indicate infection.
• Urine culture (clean catch) may reveal infection.
• Bladder or pelvic x-ray may show the presence of stones.

Treatment

Drinking 6 to 8 glasses of water or more per day, enough to increase urinary output, may help the stones pass.

Stones that are not excreted spontaneously may be removed by your health care provider using a cystoscope or a lithotripter (a small tube that passes through the urethra to the bladder). Some stones may need to be removed using open surgery.

Extracorporeal shock wave lithotripsy (ESWL) may be an alternative to surgery. In this treatment, ultrasonic waves break up stones so that they may be expelled in the urine.

Medications are rarely used to try to dissolve the stones.

Underlying causes of bladder stones should be treated. Most commonly bladder stones are seen in conjunction with benign prostatic hyperplasia (BPH) or bladder outlet obstruction.

For patients with BPH and bladder stones, transurethral resection of the prostate (TURP) can be performed with ESWL.

Expectations (prognosis)

Most bladder stones are expelled or can be removed without permanent damage to the bladder. They may recur if the underlying cause is not corrected.

If the stones are left untreated they may cause permanent damage to the bladder or kidneys.

Complications

• Recurrence of stones
• Urinary tract infection, chronic or recurrent
• Obstruction of the urethra
• Reflux nephropathy
• Acute bilateral obstructive uropathy
• Chronic bladder dysfunction (incontinence or urinary retention)

Calling your health care provider

Call your health care provider if symptoms indicate that you may have bladder stones.

Prevention

Prompt treatment of urinary tract infections or other urologic conditions may help prevent bladder stones.

Illustrations

Female urinary tract

Male urinary tract

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