Bladder stones

Overview

Bladder stones are hard lumps of minerals that form in the bladder. They're made when the minerals in urine form crystals. This often happens when the bladder does not empty all the way.

Small bladder stones might pass without treatment. But some bladder stones need medicines or surgery. Left untreated, bladder stones can lead to infections and other problems.

Symptoms

Sometimes bladder stones cause no problems. But if a stone irritates the bladder wall or blocks the flow of urine, symptoms might include:

• Lower belly pain.
• Pain when passing urine.
• Urinating more often.
• Difficulty urinating or having a urine flow that stops.
• Blood in the urine.
• Cloudy urine or darker urine than usual.

Causes

Bladder stones can develop when the bladder doesn't empty all the way. When this happens, there are more minerals than fluid in the urine, making it concentrated. Concentrated urine can turn into crystals that form stones.

Some infections can lead to bladder stones. Sometimes a condition that affects the bladder's ability to hold or get rid of urine can result in bladder stones. Anything in the bladder that shouldn't be there, called a foreign object, also can cause a bladder stone to grow on top of it.

Most often, the following conditions cause bladder stones:

• Prostate gland enlargement. An enlarged prostate, also called benign prostatic hyperplasia (BPH), can cause bladder stones. The prostate gland makes fluid that leaves the body with sperm. An enlarged prostate can block the flow of urine, keeping the bladder from emptying all the way.
• Damaged nerves. Nerves carry messages from the brain to the bladder muscles. They tell the bladder when to tighten or release. If these nerves are damaged, from a stroke, a spinal cord injury or another health problem, the bladder might not empty all the way. This is called neurogenic bladder.

Other possible causes of bladder stones include:

• Swelling and irritation, called inflammation. Bladder inflammation, sometimes caused by urinary tract infections or radiation therapy to the pelvis, can lead to bladder stones.
• Medical devices. Slender tubes put into the bladder to help urine drain, called bladder catheters, can cause bladder stones. So can objects that get into to the bladder by accident, such as a urinary stent. Mineral crystals, which later become stones, tend to form on top of these devices.
• Kidney stones. Stones that form in the kidneys aren't the same as bladder stones. They grow in different ways. But small kidney stones can break off and pass through the ureter to get into the bladder. If they stay in the bladder, they can grow into bladder stones.

Risk factors

Men, especially those over 50, are more likely to have bladder stones. But women and children also can get them.

Conditions that can raise the risk of bladder stones include:

• A blockage. Any condition that blocks the flow of urine from the bladder to the tube that carries urine out of the body, called the urethra, can lead to bladder stones forming. There are several causes. The most common is an enlarged prostate.
• Nerve damage. Stroke, spinal cord injuries, Parkinson's disease, diabetes, a herniated disk and a number of other problems can damage nerves that control how the bladder works.

Complications

Bladder stones that don't pass, even if they don't cause symptoms, can lead to problems, such as:

• Ongoing, called chronic, bladder problems. Untreated bladder stones can cause long-term urinary problems, such as pain or peeing, also called urinating, often. Bladder stones also can get stuck in the opening where urine leaves the bladder to enter the urethra. This can block the flow of urine.
• Urinary tract infections. Bladder stones can cause repeated infections caused by germs in the urinary tract.

Prevention

You may not be able to prevent a condition that causes bladder stones. But you may be able to lower the chances of getting bladder stones. Follow these tips:

• Make a medical appointment soon after urinary symptoms start. Early diagnosis and treatment of an enlarged prostate, a urinary tract infection or another condition might lower the risk of getting bladder stones.
• Drink a lot of fluids. Drinking more fluids, especially water, may help prevent bladder stones. Fluids water down the concentration of minerals in the bladder. How much water to drink depends on age, size, health and level of activity. Ask a member of your healthcare team how much fluid to drink.

Diagnosis

Diagnosing bladder stones might include:

• A physical exam. A healthcare professional feels the lower belly to see if the bladder is larger than usual, called distended. You may have a rectal exam to see if the prostate is larger than usual.
• A urine test. A sample of urine might be checked for tiny amounts of blood, germs and minerals that have turned into crystals. A urine test also looks for a urinary tract infection, which can cause bladder stones or be the result of them.
• CT scan. CT uses X-rays and computers to make pictures of the inside of the body. CT can find even very small stones. It's one of the bests tests for finding bladder stones.
• Ultrasound. This test bounces sound waves off organs and other structures in the body to make images. These can help find bladder stones.
• X-ray. An X-ray of the kidneys, ureters and bladder might show bladder stones. Some types of stones don't show up on X-rays, however.

Treatment

Drinking a lot of water might help a small stone pass on its own. However, because bladder stones are often caused by problems with emptying the bladder, extra water might not make a stone pass.

Most of the time, stones need to be removed. Ways to do this include breaking stones apart or having surgery to remove them.

Breaking stones apart

One method involves getting a numbing medicine, called a local anesthetic, or being put in a sleep-like state, called general anesthesia. Then a small tube with a camera at the end goes into the bladder so that the stone can be seen. A laser, ultrasound or other device breaks the stone into small pieces and flushes them from the bladder.

Surgical removal

Sometimes, bladder stones are too large or too hard to break up. These need surgery to remove them.

When bladder stones are the result of a bladder blockage or an enlarged prostate, this condition needs treatment at the same time as the bladder stones. This most often involves surgery.

Preparing for your appointment

You'll likely start by seeing a primary healthcare professional first. You may then be referred to a doctor who specializes in treating urinary tract conditions, called a urologist.

What you can do

To get ready for your appointment:

• Write down your symptoms and when they began.
• Note key information about yourself, including major stresses or recent life changes.
• List all medicines, vitamins or supplements you take, including doses.
• Know about pre-appointment restrictions. Ask if there's anything you need to do before your appointment, such as restrict your diet.
• Ask a family member or friend to go with you. Someone who goes with you can help you remember the things you talk about.

It's also a good idea to bring a list of questions to ask during your appointment. For bladder stones, questions might include:

• Is it possible my bladder stones could pass without treatment?
• If not, do they need to be removed? What's the best way to do that?
• What are the risks of the treatment you're talking about?
• What will happen if the stones aren't removed?
• Is there medicine I can take to get rid of bladder stones?
• Are the stones likely to come back? How can I keep that from happening?
• I have other health conditions. How can I best manage these conditions together?
• Where can I find more information?

Be sure to ask all the questions you have about bladder stones.

What to expect from your doctor

A member of your healthcare team is likely to ask you questions, such as:

• Do you always have symptoms, or do they come and go?
• How bad are your symptoms?
• Have you had a fever or chills?
• Does anything seem to make your symptoms better?
• Does anything make your symptoms worse?