Bladder Stones

Bladder stones form when substances (such as calcium oxalate) in the urine concentrate and coalesce into hard, solid lumps that lodge in the bladder. Often, several stones form at once. Normally, they are fairly small and are excreted in the urine without complications, but sometimes stones become trapped in the neck of the bladder and—as residues in the urine continue to accumulate—grow large enough to cause pain, urinary blockage, or infections, thus requiring surgical intervention. Bladder stones almost exclusively affect middle-aged and older men, but, for unknown reasons, are becoming increasingly rare.

What Causes Bladder Stones?

  • Most commonly, stones become problematic when the neck of the bladder is obstructed due to prostate enlargement, a benign growth (adenoma) within the prostate, or abnormal contraction or stricture of the bladder neck. Stones often originate elsewhere in the urinary tract (such as the kidneys), or in the bladder itself. Hereditary factors may be involved.
  • Other causes include the long-term use of a urinary catheter, chronic urinary tract infections, or a nerve injury that impairs bladder function.
  • Mild, chronic dehydration concentrates the urine, which may promote stone formation.
  • A diet high in oxalic acid (found in rhubarb, leafy vegetables, and coffee) may lead to stones.
  • Weakened area of the bladder caused by a bulging pouch in the organ (called bladder diverticulum)
  • Damage to the nerves that carry signals to the bladder muscles from the brain (called neurogenic bladder)

Symptoms of Bladder Stones

  • Interruption of the urine stream, inability to urinate except in certain positions, frequent urge to urinate but with only small amounts of urine passed
  • Blood in the urine, often only apparent in the last few drops
  • Dark urine
  • Pain—sometimes severe—in the pelvic region, genitals, lower abdomen, or lower back
  • Low-grade fever (under 102°F)

Bladder Stones Prevention

  • Drink at least eight glasses of water a day.
  • Get prompt treatment for urinary tract infections.
  • Potassium citrate can increase urine levels of citrate, which is a substance that inhibits calcium stone formation.
  • Avoid meat, eggs, and animal fats, as well as processed and fried foods.
  • Dietary changes and treatment for any underlying disorder may be helpful.

Bladder Stones Diagnosis

  • A thorough medical history and physical exam (including a rectal exam) and lower abdominal check to look for bladder distention are performed.
  • Urine samples are taken and analyzed (urinalysis).
  • Stones can be located with x-rays or ultrasound.
  • Bladder stones diagnosis can be confirmed using x-rays, ultrasound, computerized tomography (CT) scan, cystoscopy (inspection of the inside of the bladder using a scope) and intravenous pyelogram (x-rays are taken after dye is used to highlight the urinary organs).

How to Treat Bladder Stones

  • Your doctor may prescribe narcotic analgesics to relieve pain and antibiotics to treat an infection.
  • Smaller stones can be removed through a cystoscope, a tube inserted through the urethra that allows the doctor to view the stones. The scope can also be outfitted with a device that crushes the stones, after which the fragments are washed away.
  • Larger stones can be treated with extracorporeal shock-wave lithotripsy, which aims concentrated bursts of sound waves that pulverize the stones.
  • On rare occasions, very large stones may require surgical removal (suprapubic lithotomy).
  • The underlying problem (such as prostate enlargement) causing stones to be trapped in the bladder must be identified and treated to prevent recurrence.

When to Call a Doctor

  • Call a doctor for symptoms of bladder stones.
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