Bladder stones

Definition

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

Alternative Names

Stones - bladder; Urinary tract stones; Bladder calculi

Causes, incidence, and risk factors

Bladder stones are usually the result of another urologic problem, such as:

• Bladder diverticulum
• Enlarged prostate
• Neurogenic bladder
• Urinary tract infection

Approximately 95% of all bladder stones occur in men. Bladder stones are much less common than kidney stones.

Bladder stones may occur when urine in the bladder is concentrated and materials crystallize. Symptoms occur when the stone irritates the lining of the bladder or obstructs the flow of urine from the bladder.

Symptoms

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

Incontinence may also be associated with bladder stones.

Signs and tests

• Bladder or pelvic x-ray may show the presence of stones.
• Cystoscopy can reveal a stone in the bladder.
• Physical examination, including rectal examination, may reveal enlarged prostate or other urologic conditions.
• Urinalysis may show blood in the urine or an infection.
• Urine culture (clean catch) may reveal infection.

Treatment

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

Your health care provider may remove stones that do not pass on their own using a cystoscope (a small tube that passes through the urethra to the bladder). Extracorporeal shock wave lithotripsy (ESWL) uses ultrasonic waves to break up stones.

Some stones may need to be removed using open surgery.

Medications are rarely used to dissolve the stones.

Causes of bladder stones should be treated. Most commonly bladder stones are seen 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 come back if the cause is not corrected.

If the stones are left untreated, they may cause repeated urinary tract infections or permanent damage to the bladder or kidneys.

Complications

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

Calling your health care provider

Call your health care provider if you have symptoms of bladder stones.

Prevention

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

References

Ho K-LV, Segura JW. Lower urinary tract calculi. In: Wein AJ, ed. Campbell-Walsh Urology. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 84.