Bladder Stones – Diagnosis and Treatment
Diagnosis
Doctors diagnose bladder stones using a mix of physical exams, laboratory tests, and imaging techniques. They start by examining the lower abdomen to check for an enlarged bladder or prostate.
Doctors also ask the patient about symptoms like pain or trouble peeing, which can signal urinary tract stones or infection. Doctors use urinalysis to look for infection, blood, or crystal fragments in the urine.
These results can point to urinary tract infections, high calcium or uric acid levels, and the presence of cystine or struvite stones. Urinalysis also helps spot underlying issues like gout or hypercalciuria.
Doctors often use imaging studies as the next step. A CT scan gives clear images and detects even small stones, whether calcium, uric acid, or infection stones.
Ultrasound helps detect larger stones and finds hydronephrosis caused by ureteral stones. X-rays can reveal some bladder or kidney stones, but not all types show up this way.
Doctors sometimes check blood serum chemistry to look for risk factors that could cause stone recurrence. Monitoring stone size and type is important, especially if there is a history of nephrolithiasis or recent acute renal colic.
Additional Diagnostic Details:
- CT scans provide more precise detection of very small stones than X-rays.
- Ultrasound may be chosen for those who need to avoid radiation.
- Physical exams help find signs of enlarged prostate or infection that need treatment.
- Urine tests detect infection, signs of sepsis, or unusual crystals that point to particular stone types.
Treatment
Stone Fragmentation
Sometimes, drinking more water helps pass small bladder stones. If this does not work, doctors use special tools to break up stones inside the bladder. The process usually starts with pain control, sometimes with general anesthesia.
A doctor inserts a thin tube with a camera, called a cystoscope, through the urethra to see the stones. Then, the doctor uses methods like holmium laser, ultrasound, or lithotripsy to break the stones into smaller pieces.
These smaller pieces can then be flushed out of the bladder or removed with special devices. Depending on the stone size and type, procedures like litholapaxy or extracorporeal shock wave lithotripsy may be used.
Surgical Extraction
If the stones are too large or hard to break, surgeons may need to remove them directly. The surgeon makes a small cut to open the bladder and takes out the stones.
This is called surgical removal or percutaneous nephrolithotomy in some cases. If there are other problems like an enlarged prostate or a blockage, the doctor may treat them during the same procedure.
Certain medications, such as xanthine oxidase inhibitors or diuretics, may help prevent kidney stones from returning. A doctor will help determine the best treatment plan based on the type of stone and any underlying health conditions.
Getting Ready for Your Visit
Steps You Can Take Beforehand
Preparing for a visit about bladder stones can help make the appointment smoother and more useful. Make a list of all symptoms the person is experiencing.
This includes any pain in the abdomen or lower back, trouble peeing, nausea, vomiting, fever, or other concerns, even if they seem unrelated.
Write down any health details that might matter. This can include recent illnesses, changes in fluid intake, problems staying hydrated, or a history of dehydration.
It also helps to list every medication, vitamin, or supplement currently taken. People should not forget to include herbal products.
Some doctors may ask patients to avoid certain foods or drinks before testing. Check for any dietary rules or other instructions. Because a urine sample may be needed, drink enough water before the visit unless told otherwise.
Bringing a family member or friend can be helpful. They might catch details that are missed or help remember what the doctor says. Prepare questions in advance, such as:
- Can the bladder stones pass on their own?
- What treatments are available, and what are their risks?
- Is there a risk that the pain or symptoms, like nausea or flank pain, will get worse?
- How can stones be prevented in the future? Does water intake or fluid management matter?
- Are there diet or fluid restrictions?
- Will more tests be needed?
A simple table below may help organize this information:
| Item to Bring | Examples |
|---|---|
| Symptom list | Pain, vomiting, trouble urinating, fever |
| Health history | Hydration issues, recent illness |
| Medication list | Prescription, over-the-counter, vitamins |
| Prepared questions | About prevention, treatment, symptoms |
| Support person | Family or friend for help |
Topics Your Doctor May Discuss
During the appointment, the doctor will likely ask several questions. Expect to hear questions about when symptoms started, how severe they are, and if they come and go or stay the same.
The doctor may also ask what helps or worsens symptoms and if you have problems with hydration, changes in fluid intake, or episodes of dehydration.
The doctor will ask for details on pain—such as if you feel it in the lower belly or back, and whether you have related signs like fever or vomiting. Answering these as clearly as possible helps guide the next steps.
The doctor might also want to know about your fluid habits, such as how much water you usually drink daily.
