Bladder stones

Bladder stones

Definition:

Bladder stones are usually small masses of minerals that form in your bladder. Bladder stones develop when urine in your bladder becomes concentrated, causing minerals in your urine to crystallize. Concentrated, stagnant urine is often the result of not being able to completely empty your bladder. This may be due to an enlarged prostate, nerve damage or recurring urinary tract infections.

Bladder stones don't always cause signs or symptoms and may be discovered during tests for other problems. When symptoms do occur, they can range from abdominal pain to blood in your urine.
Small bladder stones sometimes pass on their own, but you may need to have others removed by your doctor. Left untreated, bladder stones can cause infections and other complications.

Symptoms:

Some people with bladder stones have no problems — even when their stones are large. But if a stone irritates the bladder wall or blocks the flow of urine, signs and symptoms can develop. These include:

• Lower abdominal pain
• In men, pain or discomfort in the penis
• Painful urination
• Frequent urination, especially during the night
• Difficulty urinating or interruption of urine flow
• Blood in your urine
• Cloudy or abnormally dark-colored urine

Causes:

Bladder stones generally begin when your bladder doesn't empty completely. The urine that's left in your bladder can form crystals that eventually become bladder stones. In most cases, an underlying condition affects your bladder's ability to empty completely.
The most common conditions that cause bladder stones include:

• Prostate gland enlargement. An enlarged prostate, or benign prostatic hyperplasia (BPH), can be a cause of bladder stones in men. As the prostate enlarges, it can compress the urethra and interrupt urine flow, causing urine to remain in your bladder.
  
• Damaged nerves (neurogenic bladder). Normally, nerves carry messages from your brain to your bladder muscles, directing your bladder muscles to tighten or release. If these nerves are damaged — from a stroke, spinal cord injury or other health problem — your bladder may not empty completely.
  
• Weakened bladder wall. Bladder diverticula are weakened areas in the bladder wall that bulge outward in pouches, and allow urine to collect.

Other conditions that can cause bladder stones include:

• Inflammation. Bladder stones can develop if your bladder becomes inflamed. Urinary tract infections and radiation therapy to your pelvic area can both cause bladder inflammation.
  
• Medical devices. Occasionally, catheters — slender tubes inserted through the urethra to help urine drain from your bladder — can cause bladder stones. So can objects that accidentally migrate to your bladder, such as a contraceptive device or stent. Mineral crystals, which later become stones, tend to form on the surface of these devices.
  
• Kidney stones. Stones that form in your kidneys are not the same as bladder stones. They develop in different ways and often for different reasons. But small kidney stones occasionally travel down the ureters into your bladder and if not expelled, can grow into bladder stones.

Complications:

Bladder stones that aren't removed — even those that don't cause symptoms — can lead to complications, such as:

• Chronic bladder dysfunction. Left untreated, bladder stones can cause long-term urinary problems, such as pain or frequent urination. Bladder stones can also lodge in the opening where urine exits the bladder into the urethra and block the passage of urine from your body.
• Urinary tract infections. Recurring bacterial infections in your urinary tract may be caused by bladder stones. 

Treatments and drugs:

Generally, bladder stones should be removed. If the stone is small, your doctor may recommend that you drink an increased amount of water each day to help the stone pass. However, because bladder stones are usually caused by the inability to empty the bladder completely, spontaneous passage of the stones is unlikely. Almost all cases require removal of the stones.

Breaking stones apart
Bladder stones are often removed during a procedure called a cystolitholapaxy. A small tube with a camera at the end (cystoscope) is inserted through your urethra and into your bladder to view the stone. Your doctor then uses a laser, ultrasound or mechanical device to break the stone into small pieces and flushes the pieces from your bladder.

You'll likely have regional or general anesthesia prior to the procedure to make you comfortable. Complications from a cystolitholapaxy aren't common, but urinary tract infections, fever, a tear in your bladder and bleeding can occur. Your doctor may give you antibiotics before the procedure to reduce the risk of infections. About a month after the cystolitholapaxy, your doctor will likely check to make sure that no stone fragments remain in your bladder.

Surgical removal
Occasionally, bladder stones that are large or too hard to break up are removed through open surgery. In these cases, your doctor makes an incision in your bladder and directly removes the stones. Any underlying condition causing the stones, such as an enlarged prostate, may be corrected at the same time.