Bladder stones: Concerning signs from cystitis

     Bladder stone disease is a condition that often starts with initial symptoms that may be overlooked, such as pain during urination or frequent urination. If not treated properly, patients may experience severe consequences, including serious infections or urinary tract obstruction. Awareness and observation of signs from cystitis are therefore crucial for effective prevention and treatment.

Bladder Stones

     Bladder Stones are caused by frequent urinary tract obstruction that leads to stone sediment. These appear as masses of minerals that precipitate or crystallize, ranging from very small sizes to larger than 5 centimeters, and can be either hard or soft.

Causes of Bladder Stones

Generally, bladder stones can occur in two ways:

• Stones from the kidneys or ureters that drop down: and accumulate, increasing in size within the bladder.
• Stones that form in the bladder itself: caused by incomplete bladder emptying. This can be due to conditions like Benign Prostatic Hyperplasia (BPH) obstructing the urinary tract, urethral strictures, or bladder dysfunction. Over time, residual urine creates sediment that gradually grows into stones.

Symptoms of Bladder Stones

Patients often show no symptoms. Doctors frequently find them by chance during abdominal X-rays for other conditions, such as abdominal or back pain. Common symptoms when present include:

• Chronic lower abdominal pain: sometimes accompanied by chronic back pain.
• Abnormal or interrupted urination: (due to stones blocking the urethra), causing frequent trickling, difficulty urinating, and a burning sensation.
• Blood in the urine (hematuria) or tea-colored urine: Some may pass small stones or gravel, or have cloudy white urine resembling flour mixture.
• If a stone completely blocks the urethra: patients will experience severe lower abdominal pain, inability to urinate, and acute urinary retention.
• Frequent cystitis (bladder inflammation): leading to lower abdominal pain, back pain, burning urination, and fever.

Treatment of Bladder Stones

The treatment guidelines for bladder stones are divided into two steps:

1. Removing the Stones

If the stones are very small, the doctor may suggest drinking plenty of water to help the body pass them naturally. Generally, there are three main methods for removal:

• Cystolitholapaxy (Endoscopic procedure through the urethra)
• Extracorporeal Shock Wave Lithotripsy (ESWL)
• Surgery

2. Treating the Root Cause

Removing the stone without addressing the cause may lead to recurrence. Examples of cause-based treatments include:

• If stones are caused by urinary retention, the underlying cause must be diagnosed and treated, such as prostate surgery (endoscopic) for BPH or urethral dilation for strictures.
• If caused by bladder dysfunction (e.g., poor bladder contraction), intermittent catheterization may be necessary.

Edited

19/09/2022