Remove bladder stones • Which symptoms are necessary?

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Bladder stones are deposits that form in the bladder from crystals. In most cases, bladder drainage problems are the cause, rarely are kidney stones that have been flushed into the bladder with the urine. The symptoms are significantly less dramatic than with kidney stones, but bladder stones have to be surgically removed in some cases.

Bladder stones show an ultrasound or X-ray examination.
© iStock.com/Carlo107

Bladder stones are deposits in the bladder (concretions) that are made up of urine components and can become as large as chicken eggs. They belong to the group of urinary stones, which are divided into kidney stones, ureter stones and bladder stones.

Around 1.2 million people in Germany are treated for urinary stone disease each year, only a small part of which are bladder stones. These are particularly common in older men and overweight people.

Cystitis: what relieves the symptoms

Cystitis: what relieves the symptoms

What causes bladder stones?

When it comes to the causes of bladder stones, a distinction is made between primary and secondary bladder stones. Secondary bladder stones are deposits that have formed in another organ, such as a kidney, and enter the bladder through the ureters. Secondary bladder stones are far less common than primary bladder stones because the stones that have entered the bladder are often simply flushed out through the urethra.

One speaks of primary bladder stones if the deposits develop directly in the bladder through the crystallization of special salts. If the salt in question has too high a concentration, it first forms a small lump on which more and more layers are deposited over time. As a result, the so-called concrement grows and gets bigger and bigger.

In most cases, blockage of the bladder outlet or urethra is responsible for the development of bladder stones. With such a drainage disorder, the bladder cannot be completely emptied, the urine remains disproportionately long in the bladder and crystals form.

An enlarged male prostate is often the trigger for a urinary drainage disorder. Scars after surgery can also cause the urethra to narrow. Rarely is there a tumor or spinal cord damage in which the muscles of the bladder are paralyzed. Due to anatomical malformations, urinary drainage can also be disturbed in children in rare cases.

Other potential triggers for bladder stones are:

  • frequent bladder infections

  • incorrect drinking behavior (insufficient fluid intake)

  • improper nutrition (with lots of animal fats and proteins)

  • severely restricted physical movement (e.g. long, illness-related lying)

  • Foreign objects in the bladder (such as a bladder catheter)

  • Metabolic disorders (e.g. overactive thyroid)

  • congenital metabolic diseases (e.g. cystinuria)

The symptoms of bladder stones

Whether and in what form symptoms occur with bladder stones depends on the size, position and mobility of the bladder stones. If a bladder block closes the urinary bladder outlet, the urine builds up temporarily. This means that it is often not possible to urinate continuously, although the person affected still feels the urge to do so.

In some cases, the bladder stones irritate the bladder mucosa and even cause inflammation. In these cases, pain occurs in the lower abdomen, in the genital organs up to the back. A burning sensation when urinating and blood in the urine can also indicate bladder stones. In some cases, those affected also complain of bladder cramps or a foreign body sensation in the bladder.

Examinations and diagnosis of bladder stones

If bladder stones are suspected, a urologist is the right contact. In a detailed discussion, the patient will first inquire about symptoms, medical history and lifestyle habits. The doctor can often already assess the risk of developing bladder stones based on the person's eating habits and circumstances.

This is followed by a physical examination of the abdomen, kidneys and (in men) prostate. Blood and urine samples are also taken and analyzed in the laboratory. With an ultrasound examination (sonography) some bladder stones can be detected and the bladder examined for remaining urine.

This may be followed by further examinations, some of which are carried out by the specialist. In addition to computer tomography, urography is primarily used here, in which the excretion of urine is checked from the kidneys to the urethra using contrast media.

Bladder mirroring (cystoscopy) can also provide information about any existing bladder stones. A thin tube is inserted into the urethra and a camera is attached to the end. This enables the stones to be assessed in terms of size, number and location, but also to identify other possible causes for the blockage of urine flow.

Another examination method is the retrograde ureteropyelogram (UPG). A contrast medium is introduced into the ureter so that the bladder and ureter as well as possible stones can be displayed plastically.

Treatment of bladder stones: There are these therapy options

The type of treatment for the bladder stones depends on their composition, their size and nature as well as their location. In this way, small stones can be literally washed out by an increased hydration – mostly in connection with antispasmodic and analgesic medication.

Another way to remove the bladder stones is to dissolve them by administering medication (litholysis). Larger stones are located using an ultrasound examination and then crushed by shock waves so that they can be excreted in the urine. This form of treatment is called extracorporeal shock wave lithotripsy (ESWL).

In some cases, it is necessary to remove the bladder stones surgically. This procedure is performed through the urethra and is called transurethral lithotripsy. Alternatively, access can also be via the abdominal wall: In this procedure, known as percutaneous cystolithotomy, a thin channel is placed from the outside with the help of a puncture needle up to the bladder, through which the bladder stones can be broken and removed.

Open surgery to remove bladder stones is now very rare and only carried out if the minimally invasive procedures mentioned cannot be used. This can be the case, for example, if the doctor does not get into the bladder during the bladder mirroring because it is blocked by the stone.

Disease course and prognosis in bladder stones

If the bladder stones have been successfully removed, there is initially no complaint. However, more than half of those affected have repeated urinary stone formation. To prevent this, the patient should consult a doctor in consultation with a doctor balanced nutrition pay attention and drink plenty. In individual cases, the administration of medication can be useful.

This is how you can prevent bladder stones

A adequate hydration is important to prevent the formation of bladder stones. At least two and a half to three liters of water, fruit tea or diluted fruit juice should be drunk throughout the day. However, the consumption of black tea, coffee and alcohol should be restricted. In addition, a bladder stone removal can cause a dietary changes make sense. This can include a restriction on milk and dairy products, spinach, rhubarb and tomatoes.