Bladder stones (Part two)

Complications

Bladder stones that are not removed, even if they are asymptomatic, can cause complications such as:

• Chronic bladder dysfunction. They can cause long-term urinary problems such as pain and frequent urination. The stones can lodge at the bladder outlet, where urine exits the bladder and enters the urethra, blocking the exit of urine from the body.
• Urinary tract infections. Recurrent urinary infections can be caused by bladder stones.

Examinations and diagnosis

• Physical examination. The doctor touches the lower part of the abdomen to see if the bladder is swollen; in some cases, checks the prostate with a finger through the rectum to see if it is enlarged or not.
• Urine analysis. Under a microscope, it is checked if there is blood, bacteria, or crystals in the urine. Urine analysis also helps to determine if a urinary tract infection is the cause of the bladder stone or a consequence of it.
• Ultrasound (Echo). Ultrasounds are sound waves that, by going through different organs and structures of the body, create images that help in detecting bladder stones.
• X-ray. The X-ray of the kidneys, ureters, and bladder is performed using X-rays to help in detecting stones in the urinary system. Some types of stones are invisible in conventional radiology.
• Intravenous pyelography. This is a radiological examination, which through a special substance (contrast) that is injected into the blood through the arm vein, reaches all structures of the urinary system, kidney, ureter, and bladder. X-rays taken at different times during the procedure, reveal stones at different levels.
• Spiral CT scanner. The conventional CT scanner combines a large number of X-ray radiological images; whereas the spiral CT scanner speeds up the process by taking images more quickly accompanied by a higher determination of internal structures. It can detect very small stones and is considered one of the most sensitive tests for identifying all types of urinary bladder stones. Generally, the spiral CT scanner is used instead of intravenous pyelography.

Treatment and medication

Bladder stones generally need to be removed. If they are small, drinking large amounts of water every day is recommended to help eliminate them. However, because bladder stones are often caused by the inability to completely empty the bladder, their spontaneous passage is impossible. Almost all cases require their removal.

Breaking the stones

Bladder stones are often removed through a procedure called cystolitholapaxy. This consists of inserting a cystoscope, which is a tube equipped with a camera at the tip, into the bladder through the urethra to see the stone. Various devices that produce laser rays, ultrasounds, or mechanically break the stones can be used. The stones are broken into small pieces and removed by washing out the bladder.

Before the procedure, anesthesia is applied by numbing the lower part of the body (regional anesthesia) or general anesthesia by putting the patient to sleep.

The complications of this procedure are rare but can include urinary tract infections, bladder rupture, or hemorrhage. Antibiotics may be given before the procedure to prevent infection.

A check-up is done after a month to see if any fragments remain in the bladder.

Removing the stones through surgery

Sometimes the stones are too large or too hard to break. In these cases, open surgery (operation) is applied to remove them. The bladder is opened and the stone is removed; at the same time, if any pathology that has helped in the formation of the stone, such as an enlarged prostate, is observed, it can be corrected at the same time.

Alternative medicine

No study has confirmed that various medications can dissolve bladder stones which are generally extremely hard and require laser, ultrasounds, or other procedures to remove them.

Prevention

Bladder stones are usually caused by certain pathological conditions that are difficult to prevent, but the chances of forming bladder stones can be reduced by following these tips:

Consultation for unusual urinary signs. Early diagnosis and treatment of enlarged prostates or other urological problems can reduce the risk of forming bladder stones.

Drinking a large amount of fluids. Drinking a large amount of fluids especially water, can prevent bladder stones because fluids dilute the concentration of mineral salts in the urinary bladder. The amount of water to be drunk depends on age, body size, health condition, and activity level. The doctor should be asked for the amount of fluids that each person should drink.