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Bladder stones

 

Bladder stones are small deposits of minerals that form in the bladder. Common symptoms of bladder stones include:

  • pain when urinating
  • blood in the urine

How common are bladder stones?

In the past, bladder stones used to be a widespread condition in Ireland. This is because a major risk factor for bladder stones is a poor diet that lacks a good balance of proteins and carbohydrates.

However, due to an overall improvement in most people's diets, today bladder stones usually only affect people with underlying bladder problems, where urine stays in the bladder for longer than usual.

If urine spends a long time inside the bladder, chemicals inside can begin to clump together to form crystals. These crystals can grow larger and develop into bladder stones.

Conditions that are known to cause bladder stones include:

  • recurrent bladder infections
  • having an enlarged prostate gland
  • spinal cord injuries that result in urinary incontinence
  • long tren urinary cathethers

Outlook

A range of treatment options are available for bladder stones, so the outlook for the condition is good. Treatments for bladder stones are usually effective in removing them, and invasive surgery (surgery involving major incisions) is not usually required.

However if the underlying condition that caused the bladder stone is not treated (or it cannot be treated), there is a risk that the bladder stones may return.

Drinking plenty of water is the best way to prevent the recurrence of bladder stones.

In some cases, bladder stones do not cause any symptoms because they are often small enough to be passed out of the bladder during urination.

However, most people with bladder stones do experience symptoms because the stones either irritate the wall of the bladder or block the normal flow of urine out of the bladder.

Symptoms of bladder stones include:

  • lower abdominal (stomach) pain
  • pain in the penis and scrotum (in men)
  • pain around the back, buttocks and hips, which can be made worse when moving or exercising (in both men and women)
  • pain when urinating
  • blood in your urine
  • intermittent ("stop-start") urination
  • needing to urinate more frequently than usual and /or waking up during the night because you need to urinate
  • difficulty beginning to urinate

The most common cause of bladder stones is an inability to empty your bladder fully of urine.

Urine is produced by your kidneys. It is made up of water mixed with waste products that the kidneys remove from your blood. One of the waste products is urea, which is a chemical compound made up of nitrogen and carbon.

If urine is allowed to stay in your bladder, the chemicals inside urea will begin to stick together and form crystals. Over time, the crystals will start to harden (calcify) and form bladder stones.

Some common reasons why people are unable to empty their bladder fully are described below.

Prostate enlargement

The prostate is a small gland that is only found in men, and is located behind the pelvis. The prostate is found between the penis and the bladder, and surrounds the urethra (the tube that carries urine from the bladder to the penis).

The main function of the prostate is to help with the production of semen. In many men, the prostate becomes enlarged as they grow older. Prostate enlargement is also known as benign prostate hyperplasia.

The enlarged prostate places pressure on the urethra, interrupting the normal flow of urine, which remains in the bladder.

Neurogenic bladder

Neurogenic bladder is a condition where the nerves that the brain uses to control the bladder are damaged, which means that a person is unable to empty their bladder fully.

A neurogenic bladder can develop as a result of spinal cord damage, stroke or neurological conditions (conditions that affect the nervous system), such as spina bifida.

Most people with a neurogenic bladder require a catheter to empty their bladder. A catheter is a tube that is inserted into the urethra and moved up into the bladder. The urine is drained out of the bladder through the catheter.

In some cases, it is not possible for a person to drain their bladder fully using a catheter. This can lead to bladder stones forming inside.

Cystocele

A cystocele is a condition that affects women and develops when the wall of the bladder becomes weakened and begins to drop down on to the vagina. This can affect the normal flow of urine out of the bladder.

A cystocele can develop during a period of excessive straining, such as childbirth, chronic constipation or heavy lifting.

Bladder diverticula

Bladder diverticula are pouches that develop in the wall of the bladder. If the diverticula grow to a certain size, it can become difficult for a person to empty their bladder fully.

Bladder diverticula can be present at birth or develop as a complication of infection or prostate enlargement.

Other causes of bladder stones

Other, less common causes of bladder stones include:

  • a diet that is high in fat, sugar or salt
  • prolonged dehydration
  • vitamin A and/or vitamin B deficiency

All three of these factors can alter the chemical composition of urine, making the formation of bladder stones more likely.

However, these risk factors only tend to affect people who are living in the developing world, and they are uncommon causes of bladder stones in Ireland.

Kidneys
Kidneys are a pair of bean-shaped organs located at the back of the abdomen, which remove waste and extra fluid from the blood and pass them out of the body as urine.

If your GP suspects that you have a bladder stone, they will refer you to hospital for testing.

Testing for bladder stones

A variety of tests can be used to identify bladder stones, including an ultrasound scan or an intravenous urogram.

During an intravenous urogram, a dye is injected into vein, which will eventually travel out of your body through your urinary system. The dye shows up clearly on an X-ray, allowing any bladder stones and their location to be identified. 

Abnormalities in the bladder can also be identified using a cystoscopy. In this procedure, a thin, hollow viewing tube called a cystoscope is inserted into your urethra in order to view the inside of your bladder.

Blood and urine samples may also be tested to identify any underlying medical conditions that may be causing them.

Blood
Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.
Cystoscopy
A cystoscopy is a procedure to view the inside of the bladder using a thin instrument with a light and a tiny telescope (cystoscope), which is inserted into the urethra.
Intravenous
Intravenous (IV) means the injection of blood, drugs or fluids into the bloodstream through a vein.
Urethra
The urethra is a tube that carries urine from the bladder to the outside of the body.
Vein
Veins are blood vessels that carry blood from the rest of the body back to the heart.
X-ray
An X-ray is a painless way of producing pictures of inside the body using radiation.

If your bladder stones are small, it may be possible to flush them out of your bladder by drinking more water. The usual recommendation is to drink at least 1.2 litres (six to eight glasses) of water a day. Your GP can advise you about whether you need to increase the amount of water that you drink.

Cystolitholapaxy

If your bladder stones are large, they will need to be broken apart before they can be removed. This is usually done using a procedure known as cystolitholapaxy.

During a cystolitholapaxy, a cystoscope is inserted into your bladder. Ultrasound waves or lasers are transmitted from the cystoscope and used to break up the stones.

A cystolitholapaxy is carried out under a local anaesthetic, so that it is not painful.

During the cystolitholapaxy procedure, there is a slight risk that you will develop an infection, so you may be given antibiotics as a precaution.

Surgery

If your bladder stones are very large, surgery may be required to remove them. This is usually done using a technique called open suprapubic cystostomy.

During a cystostomy, the surgeon will make a small incision (cut) in the skin, just above your pubic hair. A further incision is made in your bladder, and the stones are then removed.

You may need to use a catheter for a number of weeks after the operation while your bladder is healing.

Blood
Blood supplies oxygen to the body and removes carbon dioxide. It is pumped around the body by the heart.
Cystoscope
A cystoscopy is a procedure to view the inside of the bladder using a thin instrument with a light and a tiny telescope (cystoscope), which is inserted into the urethra.
Painkillers
Analgesics are medicines that relieve pain. For example paracetamol, aspirin and ibuprofen.
Ultrasound
Ultrasound scans are a way of producing pictures of inside the body using sound waves.

Drink plenty of water

The most effective way to prevent bladder stones developing (or returning) is to drink plenty of water.

Exactly how much water you should drink will depend on:

  • your age
  • your size
  • your level of physical activity
  • whether you have any underlying health conditions.

Your GP can advise you on how much water to drink.

Eat a healthy balanced diet

Eating a balanced diet can also help prevent the formation of bladder stones. A low-fat, high-fibre diet is recommended, including plenty of fresh fruit and vegetables (at least five portions a day) and whole grains.

It is also important to limit your consumption of sugar and salt because both of these substances can increase the risk of bladder stones developing. Try not to eat more than 6g (0.2oz) of salt a day.

Many foods such as fruit and dairy products contain natural sugars, so you can get the sugar that your body needs by eating foods such as these.

Avoid food and drink that have had additional sugar added to them, such as:

  • fizzy drinks
  • sweets
  • chocolate
  • biscuits
  • ice cream
  • jam
  • cakes
  • pastries

Content provided by NHS Choices www.nhs.uk and adapted for Ireland by the Health A-Z.