Bladder stones simply put are stones inside the urinary bladder. They are also called vesical calculus. Like other stones in the urinary tract, bladder stones are composed of minerals excreted in the urine. They most commonly form when the bladder is not capable of totally empty and some residual urine remains behind. Over time this urine gets concentrated which can also occur in periods of dehydration.
Most of the time bladder stones are silent i.e. they do not reason any trouble. They are incidentally discovered on getting an ultrasound or an X-ray for some other problems. But at times they can reason problems such as:
Intermittency of urinary stream i.e. the urine flow starts and stops or the urine flow suddenly gets poor whiles the passage of urine. This occurs when the stone comes and blocks the bladder neck.
Blood in urine or hematuria- The stone can irritate the mucosa of the bladder and reason some bleeding which comes out mixed with urine.
Weak urinary stream- When the bladder stone becomes big in size and obstructs the outflow (bladder neck) then the urinary stream gets narrow and the patient may have to strain to pass urine.
- Pain in the lower abdomen
- Pain in one or both of the testes and penis
Infection in the urine leading to fever (can be associated with chills and rigors) – This occurs because the urinary bladder is never completely empty as the stone obstructs the complete outflow of urine. This residual urine is in turn subject to getting infected.
In most cases, bladder stones are, to begin with, small kidney stones. These stones pass from the kidney through ureters and enter the bladder. When such stones are not capable to come out from the urine passage they grow in size over time due to further mineral deposits around the stone.
Enlarged prostate- The prostate gland in males enlarges with age and can lead to a reduced outflow of urine which in turn can lead to a situation suitable for stone formation.
Stricture urethra- In patients whose urethral passage is narrowed due to previous trauma/infections/catheterization or inflammation, urine flow is weak and the bladder doesn’t totally empty leading to concentrated urine and stone formation.
Neurogenic bladder- Patients with neurogenic bladder or atonic bladder are never able to totally empty their urine. At times they are on clean intermittent self-catheterization which also makes the urine susceptible to infections.
How to diagnose a bladder stone?
Your treating urologist after listening to your symptoms and physical examination may suspect the presence of bladder stones and may order a few tests to confirm the diagnosis.
Urine examination- This includes a urine routine and microscopy to look for the presence of mineral crystals as well as a culture and sensitivity test to rule out the presence of infection.
Ultrasound- This is a first-line test as there is no radiation exposure to the patient. This test besides telling about the presence of bladder stones also tells us about the situation of the kidneys and the completeness of bladder emptying.
X-ray KUB- Any radio-opaque stone in the bladder can simply be seen on an x-ray.Leave a reply