Bladder stones (also called cystolith) is one of the most often cases of our patients.
Signs and symptoms
Bladder stones are small particles that can form in the bladder. In most cases, bladder stones develop when the urine becomes very concentrated or when the bladder is dehydrated. This enables minerals, such as calcium or magnesium, crystallize and form stones. Bladder stones can vary in number, size and consistency. In some cases, the stones do not cause any symptoms and discovered incidentally on plain radiographs. However, when there are pronounced symptoms, they may include the hardness of the lower abdomen and back pain, difficulty urinating, frequent urination at night, fever, painful urination and blood in the urine. Most people complain about the wave-like pain. Pain may also be nausea, vomiting and chills.
Bladder stones vary in size, shape and texture. Some are small, hard and smooth, while others are huge, have thorns and very soft. May be one or more stones in bladder. Stones are more common in men with an enlarged prostate. Most prostate presses on the urethra and difficult urination. Eventually, the bladder urine stasis occurs and minerals such as calcium, begin to precipitate. There are other reasons. For example, individuals who have undergone spinal cord injury, paralysis, or nerve damage. When nerves are damaged the rear surface, the bladder can not be devastated, that leads to stagnation of urine.
Causes
Bladder stones can form when the kidneys, bladder, ureters inflamed, the urine becomes too concentrated or dehydrated body. While calcium and magnesium minerals crystallize into stones, which can then cause symptoms such as pain in the lower back or abdominal pain, or difficulty urinating. To stones in the bladder can also lead to use of urinary catheters. Using these tubes can lead to infection, which irritates the bladder that leads to the formation of stones. Finally, kidney stones can go down the ureter into the bladder. In recent years, scientists have found some evidence that chronic irritation of the bladder increases the likelihood of developing bladder cancer. Incontinence, schistosomiasis – a disease caused by Schistosoma haematobium is also involved in the development of urinary stones .
Diagnostics
Diagnosis of bladder stones include urinalysis, ultrasound, X-rays, or cystoscopy (viewing bladder through a small slim camera in urethra). Intravenous pyelogram may also be used to assess the presence of kidney stones. This test involves injecting a radiopaque agent, which is transmitted by the urinary system. Then every few minutes x-rays are performed to determine whether there is an obstacle in deriving the agent from the bladder. To date, intravenous pyelogram replaced by CT (computed tomography), which is more sensitive and can identify very small stones that are not visible in the other diagnostics.
Treatment
Increased intake of fluids may facilitate the passage of small stones in the bladder. Nevertheless, to remove large stones may require different treatments.
Crushing stones in the bladder can be achieved by using a cystoscope, which is inserted into the bladder. Urologist visualizes stone and uses ultrasonic energy or laser lithotripsy, reaching stone fragmentation into small pieces, which are then washed out of the bladder. Some stones are too high even for the treatment of cystoscopic technique. In such a case, may require open capsulotomy, during which the bladder incision and stones are removed manually.
Cystolithotomy
It is a surgical procedure to remove bladder stones in case of very large size. It is not open surgery and minimally invasive approach in which small holes are made in the abdomen. Most of the procedures for removal of stones in the bladder can be solved endoscopically (minimally invasive).
Cystolithotomy performed under general anesthesia as an inpatient procedure. The first step is studied cystoscopic bladder, ie, an incision is made in the lower abdomen. Once the stone is removed, recovering the bladder and through the urethra into the urinary bladder the catheter is inserted. Most patients do not have serious side effects, but after surgery may be a slight burning sensation and slight bleeding. More serious side effects are infections of the bladder, the need for long-term use of the catheter, as well as infections in the surgical incision. Rare side effects may include delayed bleeding requiring removal of clots or further surgery, injury cause scarring of the urethra, fever and more serious infection requiring prolonged hospital stay.
