Overview
Bladder stones are hard masses of minerals in your bladder. Bladder stones develop when the minerals in concentrated urine crystallize. This often happens when you can’t completely empty your bladder.
Signs and symptoms can vary from severe abdominal pain to blood in your urine. Sometimes, bladder stones don’t cause any symptoms.
Small bladder stones may pass without treatment, but some need medications or surgery. Left untreated, bladder stones may lead to infections and other complications.
Symptoms
Sometimes bladder stones — even large ones — cause no problems. But if a stone irritates the bladder wall or blocks the flow of urine, signs and symptoms may include:
- Lower abdominal pain
- In men, pain or discomfort in the penis or testicles
- A burning sensation during urination
- Frequent urination
- Difficulty urinating or interrupted urine flow
- Blood in the urine
- Cloudy or abnormally dark-colored urine
Causes
Bladder stones usually develop when your bladder doesn’t empty completely, and the urine forms crystals. Some infections can lead to bladder stones, and sometimes an underlying condition that affects the bladder’s ability to hold, store or eliminate urine can result in bladder stone formation. Any foreign materials present in the bladder tend to cause bladder stones.
The most common conditions that cause bladder stones include:
- Prostate gland enlargement. An enlarged prostate (benign prostatic hyperplasia) can cause bladder stones in men. The enlarged prostate can obstruct the flow of urine, preventing complete emptying of the 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.
Other possible causes of bladder stones include:
- Inflammation. Bladder inflammation, sometimes caused by urinary tract infections or radiation therapy to the pelvis, can lead to bladder stones.
- Medical devices. Bladder catheters — slender tubes inserted through the urethra to help urine drain from your bladder — may cause bladder stones. So can objects that accidentally migrate to your bladder, such as a contraceptive device or urinary 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. But small kidney stones may travel down the ureters into your bladder and, if not expelled, can grow into bladder stones.
Risk factors
Bladder stones are common in children in developing countries — often because of dehydration, infection, abnormalities in the urinary tract and a low-protein diet. In other parts of the world, bladder stones occur primarily in adults.
Conditions that raise the risk of bladder stones include:
- Bladder outlet obstruction.Any condition that blocks the flow of urine from your bladder to the urethra — the tube that carries urine out of your body — can lead to bladder stone formation. Bladder outlet obstruction has many causes, but the most common is an enlarged prostate.
- Neurogenic bladder.Stroke, spinal cord injuries, Parkinson’s disease, diabetes, a herniated disk and a number of other problems can damage the nerves that control bladder function. Some people with neurogenic bladder may also have an enlarged prostate or other type of bladder outlet obstruction, which further increases the risk of stones.
Complications
Bladder stones that aren’t expelled — even those that don’t cause symptoms — can lead to complications, such as:
- Chronic bladder dysfunction. 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 urine passage.
- Urinary tract infections. Recurring bacterial infections in your urinary tract may be caused by bladder stones.
Prevention
Bladder stones usually result from an underlying condition that’s hard to prevent, but you can decrease your chance of developing bladder stones by following these tips:
- Ask about unusual urinary symptoms. Early diagnosis and treatment of an enlarged prostate or another urological condition may reduce your risk of developing bladder stones.
- Drink plenty of fluids. Drinking more fluids, especially water, may help prevent bladder stones because fluids dilute the concentration of minerals in your bladder. How much water you should drink depends on your age, size, health and level of activity. Ask your doctor what’s an appropriate amount of fluid for you.
Diagnosis
Diagnosing bladder stones may involve:
- A physical exam. Your doctor will likely feel your lower abdomen to see if your bladder is enlarged (distended) or may perform a rectal exam to determine whether your prostate is enlarged. You’ll also discuss any urinary signs or symptoms that you’re having.
- Analysis of your urine (urinalysis). A sample of your urine may be collected and examined for microscopic amounts of blood, bacteria and crystallized minerals. A urinalysis also helps determine whether you have a urinary tract infection, which can cause or be the result of bladder stones.
- Computerized tomography (CT). CT uses X-rays and computers to quickly scan and provide clear images of the inside of your body. CT can detect even very small stones and is considered one of the most sensitive tests for identifying all types of bladder stones.
- Ultrasound. An ultrasound, which bounces sound waves off organs and structures in your body to create pictures, can help your doctor detect bladder stones.
- X-ray. An X-ray of your kidneys, ureters and bladder helps your doctor determine whether stones are present in your urinary system. But some types of stones aren’t visible on conventional X-rays.
Treatment
Bladder stones generally need to be removed. Your doctor may recommend drinking a lot of water each day to help a small stone pass naturally. However, because bladder stones are often caused by the inability to empty the bladder completely, this may not be enough to make the stone pass. Most cases require removal of the stones.
Breaking stones apart
Bladder stones are often removed during a procedure called a cystolitholapaxy (sis-toe-lih-THOL-uh-pak-see). 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.
Hand-held lithotripters use ultrasonic energy to break up the stone into pieces small enough to pass in the urine. Holmium laser lithotripsy uses a laser to break up the stone.
Before the procedure, you’ll likely be given an anesthetic that numbs the lower part of your body (regional anesthesia) or that makes you unconscious and unable to feel pain (general anesthesia). Complications from a cystolitholapaxy aren’t common, but urinary tract infections, fever, a tear in your bladder or bleeding can occur. Your doctor may give you antibiotics before and after the procedure to reduce the risk of infections.
About a month after the cystolitholapaxy, your doctor will likely confirm that there are no remaining stone fragments in your bladder.
Surgical removal
Occasionally, bladder stones that are large or too hard to break up are removed through surgery. In these cases, your doctor makes an incision in your bladder and directly removes the stones.
Alternative medicine
No studies have confirmed that herbal remedies can break up bladder stones, which are extremely hard and usually require a laser, ultrasound or other procedure for removal.
Always check with your doctor before taking any alternative medicine therapy to be sure it’s safe and that it won’t adversely interact with other medications you’re taking.
Preparing for your appointment
If you have signs and symptoms of bladder stones, you’re likely to start by seeing your family doctor or a general practitioner. However, you may be referred to a doctor who specializes in treating disorders of the urinary tract (urologist).
What you can do
To get ready for your appointment, make a list of:
- Any symptoms you’re experiencing, including any that may seem unrelated to your condition
- Key personal information, including any major stresses or recent life changes
- All medications you’re taking, as well as any vitamins or other supplements
- Questions to ask your doctor, in order of importance
In addition:
- Be aware of any pre-appointment restrictions. Ask if there’s anything you need to do in advance, such as restrict your diet.
- Ask a family member or friend to come with you. Someone who accompanies you may remember information that you missed or forgot.
For bladder stones, some basic questions to ask your doctor include:
- Can bladder stones pass without treatment?
- If not, do they need to be removed, and what’s the best method?
- What are the risks of the treatment you’re proposing?
- What will happen if the stones aren’t removed?
- Is there any medication I can take to eliminate bladder stones?
- How can I keep them from coming back?
- I have other health conditions. How can I best manage these conditions together?
- Are there any dietary restrictions that I need to follow?
- Will the stones come back?
- Do you have any printed materials that I can have? What websites do you recommend?
Don’t hesitate to ask additional questions that may come up during your appointment.
What to expect from your doctor
Your doctor is likely to ask you a number of questions, such as:
- When did you begin experiencing symptoms?
- Have your symptoms been continuous or occasional?
- How severe are your symptoms?
- Have you had a fever or chills?
- Does anything seem to improve your symptoms?
- What, if anything, appears to worsen your symptoms?
