Urinary Bladder Stone - Symptoms, Causes & Treatment

When large amounts of minerals in urine accumulate and crystallise, they form a hard mass, commonly known as a Urinary Bladder Stone. These stones usually form when the bladder doesn’t get emptied properly, and some amount of urine gets left behind after peeing. 

Bladder stones or bladder calculi may not require any treatment as sometimes they pass out on their own. But mostly, bladder stone removal requires medicines or minimally invasive procedures. However, if the stone is too large, open surgery is considered the best treatment choice. These stones can cause urinary tract infections and other health risks if left untreated.

In medical terms, bladder stones are also known as “vesical calculi” or “cystoliths”. These stones are formed due to residual urine in the bladder. Certain health conditions, such as prostate gland enlargement, prevent the bladder from expelling urine completely. When some amount of urine is left in the bladder after peeing, uric acid, and other minerals present in it, get concentrated and crystallised, making a bladder stone. 

Urinary bladder stones may stay inside the body without causing any symptoms. These stones are usually found while diagnosing other diseases, especially during an imaging procedure (for example, an X-ray).

Urinary bladder stones are formed when urine doesn’t completely pass out of the body. The inability of the bladder to fully get empty may be due to some underlying medical conditions. These conditions may include:

1. Prostate Enlargement 
   With age, the prostate may get bigger in men. The enlarged prostate can put pressure on the urethra (the tube which expels urine from the body), thus interrupting the urine flow. This may cause the urine to pool inside the bladder after peeing. 
2. Augmentation Cystoplasty 
   Generally, those people who have urinary incontinence ( an uncontrollable urge to urinate, sometimes resulting in a leakage of urine) undergo this procedure. It is performed to enlarge the size of the bladder and improve its functioning. In this procedure, the surgeon may take tissue from the bowel to enlarge the bladder size so that it can hold more urine. But this can also make the urine stay in the bladder for a long time, leading to the concentration of minerals. 
3. Dehydration 
   Drinking enough water helps dilute the minerals present in the urine so they can easily pass out of the body. But due to dehydration, these minerals can get crystalised in the concentrated urine leading to the risk of stone formation. 
4. Neurogenic Bladder 
   In case of nerve damage due to a spinal cord injury, stroke, or congenital disease, the normal functioning of the bladder may get affected. Such people need a catheter to drain the urine from the bladder. But sometimes, these catheters may not empty the bladder fully. This may cause a urinary bladder stone.
5. Cystocele
   Cystocele only occurs in women. It is a condition in which the bladder walls get weak over time and fall into the vagina, blocking the urine flow. 
6. Medical Devices
   If the patient has a medical device inside the bladder, such as a catheter, crystals of minerals may get deposited on its surface. This can happen if the device stays inside the bladder for more than the recommended time. These crystallised minerals can develop into a urinary bladder stone over time. 
7. Bladder Diverticula
   It is a condition in which pouches or pockets form inside the bladder, obstructing the urine flow. This can cause the urine to pool inside the bladder for a long time.

A patient with bladder stones doesn’t usually have any symptoms. But if the walls of the bladder get irritated or the urine flow gets blocked, one can experience pain and discomfort. Other urinary bladder stone symptoms may include:

1. Pain during urination 
2. Frequent urination 
3. Lower abdominal pain
4. A small amount of blood in the urine 
5. Cloudy or oddly dark urine
6. Pain and discomfort in the penis 
7. Delay in starting urination 
8. Urinary tract infection

Urinary bladder stones are more common in men than in women. And their risk increases in men over the age of 50. The following conditions may also cause bladder stones:

1. Nerve damage caused due to stroke, spinal cord injuries, diabetes, Parkinson’s disease, and congenital abnormalities can affect how the bladder works. 
2. Blockage or obstruction in the urethra (the tube through which urine exits the body) can cause urinary bladder stones.

Completely preventing bladder stones may not be possible, but following a healthy lifestyle can surely lower the risk. Following are some ways to reduce the risk of bladder stones:

1. Drink Enough Water: Staying hydrated is necessary to stop the concentration of minerals in the urine. Water helps in diluting these minerals so the body can expel them easily. However, one should ask a doctor to identify the right amount of water healthy for daily consumption. It depends on various factors, such as a person’s age, health, and level of physical activity. 
2. Get treatment for the Underlying Cause: In case of urological abnormalities, one must seek medical attention immediately for early diagnosis and treatment. Treating the underlying cause will significantly lower the risk of urinary bladder stones. Especially people over 50 must consult a doctor to find ways to empty the bladder completely if they have an enlarged prostate.

If someone is suspected of having a bladder stone, the doctor asks questions regarding the urinary signs and symptoms. He or she also performs specific tests to diagnose the underlying cause. These tests may include the following:

1. Physical Exam: The doctor feels the patient's lower abdomen to see if the bladder is enlarged. The doctor may also perform a rectal exam to rule out prostate enlargement.
2. CT Scan: It helps to detect the presence of even the smallest of stones by providing clear images of the bladder. 
3. X-ray: An X-ray of the kidneys, ureters, and bladder may help determine if a bladder stone is present. However, an X-ray may fail to detect a bladder stone sometimes.
4. Ultrasound: During this test, sound waves bounce off organs and other structures inside the body to detect the location of the bladder stone. 
5. Urine Test: In this test, the patient’s urine is examined to diagnose even a small amount of blood, bacteria, and crystallised minerals. The test also helps determine if the patient has a urinary tract infection due to a bladder stone. 
6. Cystoscopy: This procedure is performed to get a full and clear view of the bladder to detect a bladder stone. The doctor places a small thin tube with a camera attached to its head (cystoscope) inside the bladder through the urethra. The bladder is stretched by filling in a fluid to inspect its lining thoroughly.

How To Prepare for Doctor’s Consultation? 

If the patient has the signs and symptoms of a bladder stone, he or she must consult a doctor to diagnose the problem. To prepare for the doctor’s consultation, the patient must consider the following things: 

1. Make a list of all the medications, vitamins, and supplements he or she takes. 
2. All the signs and symptoms that may or may not seem related to the condition of urinary bladder stone. 
3. Any significant life changes may have led to stress or anxiety. 
4. All the questions he or she wants to ask the doctor. 

The following are some general questions to be asked about urinary bladder stones may include:

1. Can the body expel bladder stones naturally, without any treatment? 
2. If the stones cannot be passed out naturally, what can be the most suitable treatment approach for the patient? 
3. Can any type of medication help dissolve the bladder stone and remove it from the body? 
4. What can be the risks and complications involved in the treatment? 
5. What may happen if the stones remain in the body? 
6. Can the stones come back? 
7. How can bladder stones be prevented from coming back? 
8. What can be done for proper management if he or she has other medical conditions along with bladder stones?
9. Are there any dietary restrictions required? 
10. How to learn more about bladder stones? 

The questions mentioned above are for reference purposes. One must not restrict themselves to these questions. It is essential to ask all the doubts and questions about bladder stones to get complete clarity on one’s condition. 

The approach to removing urinary bladder stones depends on several factors, such as the type, size, and location of the stone. In some cases, drinking plenty of water can help dissolve the stone and pass out of the body. However, the stone is often removed by breaking them into smaller pieces using endoscopic procedures or open surgery. 

Urinary Bladder Stone Treatment without surgery

Ayurveda recommends including the following things in the diet to prevent urinary bladder stones:

1. Lemon juice with honey 
2. Coconut water
3. Lady Finger (Bhindi)
4. Horse Gram (Kollu) 
5. Basil (Tulsi) - in tea or juice

Urinary Bladder Stone Treatment with surgery

Different surgical methods are available to remove urinary bladder stones. Following are the urinary bladder stone treatment procedures:

1. Cystolithopaxy: This procedure breaks down a urinary bladder stone into smaller pieces and ultimately flushes it out of the body. It is performed under general anaesthesia so the patient doesn’t feel any pain during the procedure. Once the patient is unconscious, an instrument called a cystoscope is inserted into the bladder through the urethra. A cystoscope is a small thin tube with a camera on its end, which helps the surgeon to get a clear view inside the bladder. Once the stone is detected, a laser and ultrasound device is used to break the stone. Finally, it is flushed out of the body. 
2. Surgery: Sometimes, when the stones are too large or hard to break, surgery is required for their removal. Several surgical options exist to treat bladder stones, depending on their severity and the patient’s health condition. 
   1. Open cystolithotomy is one such procedure that is considered highly effective for stone removal. However, it is used only when the stone cannot be treated using minimally invasive endoscopic procedures.

Bladder stone keep growing in size if not treated in time. They may cause the following risks and complications:

1. Urinary tract infections 
2. Blockage in the urine flow
3. Painful or frequent urination 

If the patient experiences any of the conditions mentioned above, he or she must seek medical attention immediately. 

Making small changes in the diet and including healthy habits in daily routines, such as physical activities and proper hydration, can significantly reduce the risk of urinary bladder stones. Following are simple dietary tips to prevent bladder stones:

1. Drink Enough Water and Fluids: Staying hydrated prevents the concentration of minerals and salts in the urine. Water helps dissolve urine salts so they can easily pass out of the body. These salts can concentrate and crystallise over time if the body doesn’t have enough water. One can observe the colour of their urine to identify if their body needs more fluid or not. The light colour of urine indicates that the body is properly hydrated. If the urine is dark-coloured, it suggests that the body needs more water. Drinking citric fluids such as lemonade and orange juice can also help prevent the development of a stone. 
2. Include More Calcium in The Diet: Calcium is the most common component in a kidney or urinary bladder stone. This is why it is often believed that eating calcium-rich food can cause a bladder stone. But this is not the case. Low calcium diets increase the risk of bladder stones and even cause bone weakening. However, it is essential to note that taking calcium supplements can increase the risk of bladder stones. So, they should be taken with food. This way, they don’t cause any harm to the body. 
3. Reduce Sodium In The Diet: Eating excess salt can prevent calcium absorption in the body. When the body doesn’t absorb calcium, it gets filtered out by the kidneys as a waste product, causing high urine calcium. Gradually, a high amount of calcium in the urine can accumulate and develop into a stone. Balanced sodium consumption lowers the amount of calcium present in the urine, thus, reducing the risk of urinary bladder stones. Food that contains excess salt includes:
   1. Canned vegetables and soups 
   2. Chips and other savoury snacks 
   3. Pizza
   4. Bread rolls
   5. Chicken 
   6. CheeseFood containing the following ingredients also has excess salt:- 
      1. Monosodium glutamate
      2. Sodium nitrate
      3. Sodium bicarbonate
4. Avoid Vitamin C Supplement: Food rich in vitamin C prevents the development of stones, but consuming vitamin C supplements doubles the risk of bladder stones. Studies show that men who take vitamin C supplements are more vulnerable to the risk of bladder stones. 
5. Lower Intake of Oxalate-Rich Food: Oxalate is another compound that combines with calcium in the urine to form kidney and bladder stones. It is commonly found in food, so reducing an oxalate-rich diet can lower the risk of bladder stones. Following are examples of oxalate-rich food:
   1. Chocolate 
   2. Sugary soft drinks
   3. Spinach 
   4. Coffee
   5. Beets
   6. Peanuts 
   7. Rhubarb
   8. Soy products
   9. Wheat bran 
6. Reduce Animal Protein In The Diet: Consuming high amounts of animal protein can increase urine acid, leading to uric acid and calcium oxalate stones. Food rich in animal protein includes:
   1. Beef
   2. Poultry 
   3. Fish 
   4. Pork