Urology Conditions
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      2. Urology Conditions

      Bladder Stones

      Condition: Bladder Stones

      Brief Overview: According to Cedars Sinai, “Also called bladder calculi, bladder stones are mineral build-ups that form in the bladder, usually as a secondary urologic condition caused by a urinary tract infection or enlarged prostate. Bladder stones form when stagnated urine in the bladder becomes concentrated. Minerals in the concentrated urine then crystallize into a mass. When the mass rubs against the lining of the bladder or obstructs urination, the symptoms become recognizable. Bladder stones mainly affect men.”

      Prevalence: According to Cleveland Clinic, “Only about 5% of all stones that can develop in your urinary system are bladder stones.”

      Etiology:

      • Urinary stasis
      • BPH
      • Neurogenic bladder
      • Bladder augmentation surgery
      • Bladder diverticula
      • Cystocele
      • Chronic indwelling catheters

      Risk Factors:

      • Men > 50 years old
      • BPH
      • Spinal cord injury
      • Previous bladder surgery

      Common Medications:

      • Definitive stone treatment is procedural (endoscopic fragmentation/removal).
      • Analgesics/NSAIDs may be prescribed for pain management
      • Antibiotics if infection present

      Common Labs, Imaging, and Tests:

      • Urine tests
      • Imaging: CT, x-ray, ultrasound
      • Cystoscopy

      Common Symptoms:

      • Urinary frequency, dysuria, hematuria
      • Changes in urine color – dark, cloudy
      • Urinary urgency, incontinence
      • Abdominal pain (typically lower abdomen)
      • Urine stream dysfunction

      Common Treatments:

      • Transurethral cystolitholapaxy
      • Percutaneous suprapubic cystolitholapaxy
      • Extracorporeal shock wave lithotripsy
      • Open cystostomy
      • Treatment of any underlying etiology

      Physical Findings:

      • Often normal. Possible suprapubic tenderness, palpable distended bladder (retention)
      • DRE: enlarged prostate possible
      • Catheter present in some patients; debris/sediment in drainage

      Potential Complications and Contraindications:

      • Recurrent UTIs, hematuria, bladder irritation
      • Bladder, kidney damage
      • Urinary retention, obstructive uropathy, hydronephrosis, renal impairment
      • Bladder mucosal injury, ulceration, or diverticula
      • Recurrence if obstruction/emptying issues persist
      • Surgical complications – infection, bleeding, etc.

      General Health and Lifestyle Guidance:

      • Maintain adequate hydration, as directed by your healthcare provider
      • Timed/double voiding; manage constipation and avoid straining.
      • Catheter care education (closed system, regular changes) if needed long-term.
      • Reduce bladder irritants: caffeine, alcohol, highly acidic/carbonated drinks during symptom flares.
      • Review meds that worsen urinary retention (anticholinergics, antihistamines); advise patient to discuss further with healthcare provider
      • Encourage adherence to BPH management (if applicable) and follow-up to prevent recurrence

      Suggested Questions to Ask Patients:

      • Onset and nature of symptoms (pain, frequency, stream changes, hematuria)?
      • Prior stones, UTIs, BPH, retention, or catheter use?
      • Any fever, chills, flank pain, nausea/vomiting (red flags for infection/upper tract involvement)?
      • Ability to empty the bladder; episodes of acute retention?
      • Hydration, diet, and fluid timing; caffeine/alcohol intake?
      • Neurologic disease or neurogenic bladder history?

      Suggested Talking Points:

      • Bladder stones usually form when urine doesn’t empty well; your healthcare provider will likely work to treat the stone and the reason it formed.
      • Most stones are removed endoscopically; fixing BPH/emptying problems lowers the chance they come back.
      • Call your healthcare provider urgently for fever, severe pain, inability to urinate, or vomiting.
      • Always ask your healthcare provider for specific advice on when to call to report symptoms, and when to seek urgent/emergency care.  
      • Staying adequately hydrated and following your urology plan helps prevent recurrence.
      • If your stone is uric acid, medicines that alkalinize urine may help prevent new stones.

      Sources:

      This resource is for educational purposes only and is not a substitute for professional medical advice. The patient should always follow your healthcare provider’s instructions.

      This content was created with the assistance of AI. Any AI-generated content was reviewed by a Nurse Practitioner