TODAY LET'S TALK ABOUT BLADDER STONES

Bladder stones are small mineral masses that develop in
the bladder, usually when the urine becomes concentrated.
Urolithiasis refers to stones in any part of the urinary tract,
including the kidneys, bladder or urethra. The stones can be
called calculi . Spinal cord injuries that result in urinary
incontinence , an enlarged prostate, or recurring urinary
tract infections are common causes of concentrated and
stagnant urine. If urine remains too long in the bladder,
urine chemicals start clumping together, forming crystals
which grow and eventually develop into bladder stones.
Bladder stones used to be much more common in the UK,
USA and other developed countries, when people's diets
lacked a good balance of carbohydrates and proteins.
Today, however, most patients in industrialized nations with
bladder stones have an underlying bladder problem.
Sometimes, patients with bladder stones first know about it
after tests for other problems reveal them - they may exist
without any symptoms. Signs and symptoms of bladder
stones may include abdominal pain, pain when urinating, or
blood in urine.
A tiny bladder stone may pass out of the body on its own.
However, larger ones require medical intervention to get
them out. Untreated bladder stones can eventually result in
infections and complications.
In medical English:
A calculus is a stone within the body.
The plural of calculus (stone) is calculi (stones)
The Latin word calculus means "pebble"
A urinary calculus is a stone in the urinary tract, such
as the kidney, bladder or urethra (urine leaves the
bladder to outside the body through a tube called the
urethra)
A bladder calculus is a bladder stone
Bladder calculi are bladder stones
A renal calculus is a kidney stone
A urethral calculus is a stone in the urethra
According to Medilexicon's medical dictionary:
What are the signs and symptoms of bladder
stones?
A symptom is something the patient senses and describes,
while a sign is something other people, such as the doctor
notice. For example, drowsiness may be a symptom while
dilated pupils may be a sign.
Some patients never know they had a bladder stone, which
was small and eventually passed out during urination.
Others with no symptoms find out after undergoing tests for
some other condition. The majority of people with bladder
stones do have symptoms though, which may include:
Lower abdominal pain
Back, buttocks or hip pain, which worsens with
physical activity
Blood in urine, or the urine may be abnormally dark
Getting up during the night from sleep to urinate
Intermittent urination (urination stops and starts)
Males may experience penile and scrotal pain or
discomfort
More frequent urination
Pain when urinating
Some patients may find it hard to start urinating (have
to wait for the flow to come)
Urinary incontinence (unintentional leaking)
Bladder stones may be:
So small that they come out during urination
So large that they fill the entire bladder
Soft
Hard
Smooth
Jagged
Spiked
A single stone or many of them
What are the risk factors for bladder stones?
A risk factor is something which increases the likelihood of
developing a condition or disease. For example, obesity
significantly raises the risk of developing diabetes type 2.
Therefore, obesity is a risk factor for diabetes type 2.
Being a child in a developing nation - bladder stones
are common in children in developing nations. Mainly
because of dehydration and a diet that lacks protein.
Being an elderly male in developed nations - bladder
stones occur much more frequently in elderly males,
compared to other humans.
Age - people in developed nations aged over 50 years
have a higher risk than younger people..
Bladder outlet obstruction - this term refers to any
condition that undermines the flow of urine from the
bladder to the urethra, such as an enlarged prostate,
cystocele, bladder diverticula, certain medications and
narrowing of the urethra.
Nerves that control bladder function - any condition
that damages the nerves that control bladder function
make the likelihood of bladder stones greater, such as
a spinal cord injury, Parkinson's disease, diabetes,
herniated disk , and stroke. Patients who have a
neurological problem as well as some kind of bladder
outlet obstruction, such as an enlarged prostate have
an even greater chance of developing bladder stones.
Recurrent bladder infections - chronic (recurrent, long-
term) bladder infections cause inflammation, which
may result in the development of bladder stones.
Urinary catheters - these are slender tubes which are
inserted through the urethra to the bladder to help
drain urine. Urinary catheter use, especially long-term
use, can increase the risk of developing bladder
stones.
Kidney stones - very small kidney stones can travel
down the tubes that connect the kidneys to the bladder
(ureters) and enter the bladder, where they may
eventually grow into bladder stones.
Other factors - bladder stones are more likely if a
person's diet is high in fat, sugar or salt. A vitamin A
and/or vitamin B deficiency may also increase the
risk. These other factors are more likely to affect
people in developing nations.
What are the causes of bladder stones ?
By far the most common cause of bladder stones is the
bladder's inability to empty itself completely.
Urine, which is produced in the kidneys, consists of water
and waste products which have been removed from blood.
Urea, one of the waste products, is made of carbon and
nitrogen - (NH 2 ) 2 CO. Stagnant urine - urine that remains in
the bladder because it could not empty itself fully - leads to
the clumping together of the chemicals inside urea,
eventually resulting in the formation of crystals.
Diagnosing bladder stones
A GP (general practitioner, primary care physician), often
the first health care professional the sufferer will go to, will
interview the patient and carry out a physical exam. The
doctor will feel the lower abdomen to determine whether
there is any bladder distention (swelling). If the individual is
male a rectal exam may be done, to check the size of the
prostate.
If the GP suspects there may be bladder stones, the patient
will be referred to a hospital for tests, which may include:
Urine test (urinalysis) - a urine sample is examined for
blood, bacteria and crystallization of minerals.
Cystoscopy - a cystoscope, a slender tube with a tiny
camera at the end is inserted through the urethra and
into the bladder. Water flows through the cystoscope
into the bladder, filling it up. This stretches the bladder
wall so that the doctor can see the inside of it more
clearly. With a cystoscope the doctor can determine
whether there are any bladder stones, how many there
are, what they are like, and where exactly they all are.
Spiral CT (computerized tomography) scan - the CT
scanner uses digital geometry processing to generate
a 3-dimensional (3-D) image of the inside of an object.
The 3-D image is made after many 2-dimensional (2-
D) X-ray images are taken around a single axis of
rotation - in other words, many pictures of the same
area are taken from many angles and then placed
together to produce a 3-D image. It is a painless
procedure. A spiral CT scans more rapidly and with
greater definition - even tiny stones can be detected.
This is considered the most sensitive test for detecting
all types of bladder stones.
Ultrasound scan - this device uses ultrasound waves
which bounce off tissues; the echoes are converted
into a sonogram (an image) which the doctor can see
on a monitor. The doctor can get an inside view of soft
tissues and body cavities; which in this case would be
the bladder and inside the bladder.
X-ray - may be used to determine whether there are
stones anywhere in the urinary system, including the
kidneys, ureters and bladder. X-rays may not detect all
types of stones.
Intravenous pyelogram (intravenous urogram) - a dye
is injected into a vein in the arm. The dye flows into
the kidneys, ureters and bladder, which are revealed in
X-ray images. Several X-rays are taken, at specific
points in time.
What are the treatment options for bladder
stones?
Bladder stones should not remain in the bladder. Small ones
may usually be flushed out by drinking more water - at least
6 to 8 glasses (1.2 liters) of water a day. Patients should be
guided by what their doctor tells them.
If the bladder stone is too large to be flushed out on its
own, the doctor may need to remove it.
Cystolitholapaxy - crushing the stones followed by
irrigation to remove fragments. A cystoscope is
inserted through the urethra and into the bladder.
Ultrasound waves or lasers are transmitted from the
cystoscope and aimed at the stones, breaking them
up. They are then flushed out.
The patient will have either a local or general
anesthetic for the procedure. Complications are rare,
but if they do occur may include urinary tract
infections, a bladder tear, and bleeding. Patients are
usually administered antibiotics to reduce infection
risk.
Approximately one month after the cystolitholapaxy
there is a follow-up meeting with the doctor to check
that no fragments remained behind in the bladder.
Surgery - if the bladder stones are too hard to crush, or
too large, open surgery may be needed. The surgeon
makes an incision just above the pubic hair, and
another incision in the bladder and directly removes
the stones. If there is an underlying condition linked to
bladder stones, such as an enlarged prostate, this may
be corrected too. The patient may need to use a
urinary catheter until the bladder heals.
What are the possible complications of
bladder stones ?
Untreated bladder stones can eventually lead to:
Chronic bladder dysfunction - the bladder does not
work properly and the individual may have to urinate
frequently, there may be some varying degrees of
urinary incontinence as well. A stone may become
stuck in the opening where the urethra joins the
bladder, causing blockage and consequent urination
difficulties.
Urinary tract infections - bladder stones significantly
increase the risk of recurrent urinary tract infections.
Bladder cancer - untreated bladder stones can increase
the risk of bladder cancer .