Why do bladder stones form?
Normally, the bladder empties completely with each urination, and the salts do not have time to crystallize. If a significant volume of urine remains after urination, it stagnates, becomes concentrated and becomes a medium for crystal growth.
- Prostate adenoma is the most common cause in men: an enlarged gland blocks the exit from the bladder
- Urethral stricture and bladder neck sclerosis
- Neurogenic bladder in spinal cord injury, multiple sclerosis, diabetic neuropathy
- Bladder diverticulum - a protrusion of the wall where urine constantly stagnates
- Foreign bodies: fragments of catheters, suture material, migrated meshes - salts build up around them
- Prolonged use of a urethral catheter or cystostomy
- Prolapse of the pelvic organs in women
- A stone that migrated from the kidney, which could not pass through the urethra and continued to grow in the bladder
Understanding the cause is fundamental: removing a stone without removing the obstacle to the outflow of urine almost guaranteed leads to the formation of a new stone within several years.
Symptoms
- Pain in the lower abdomen, above the pubis, aggravated by movement and physical activity
- A sudden interruption of the stream of urine, which resumes when changing body position, is the most characteristic symptom
- Pain radiating to the head of the penis, to the perineum
- Frequent and painful urination
- Cloudy urine, bloody
- Feeling of incomplete emptying
- Incontinence or, conversely, urinary retention
- In some patients, stones do not produce symptoms for a long time and are detected on ultrasound by chance.
Diagnostics
- Ultrasound of the bladder with determination of residual urine is the main screening method; the stone is clearly visible when the bladder is full
- Cystoscopy is a direct examination of the bladder cavity: allows you to see the stone, assess the condition of the mucosa and identify associated changes
- CT scan - for multiple stones, suspected diverticulum or concomitant kidney stones
- Uroflowmetry - assessment of the degree of disturbance of urine outflow
- TRUS and PSA in men - assessment of the prostate as a likely cause
- General analysis and urine culture
Treatment
Bladder stones do not pass on their own and are not dissolved by medications: they require removal. The modern approach is endoscopic, through the urethra, without incisions.
- Contact cystolithotripsy - the stone is destroyed by a mechanical or pneumatic lithotripter through a cystoscope and washed out
- Laser cystolithotripsy - destruction with a holmium laser; suitable for dense and multiple stones
- Percutaneous cystolithotripsy - access through a puncture above the pubis for very large or multiple stones
- Epicystolithostomy - open removal; used for giant stones or when endoscopic access is not possible
- Simultaneous elimination of the cause: TURP of the prostate, TURP or bladder neck incision, urethrotomy, diverticulectomy
Prevention of relapse
- Mandatory treatment of the underlying disease: adenoma, stricture, sclerosis of the bladder neck
- Monitoring the volume of residual urine by ultrasound
- Sufficient drinking regime
- Timely replacement of catheter and cystostomy in patients forced to use them
- Regular catheterization according to the scheme for a neurogenic bladder
- Treatment of urinary tract infections
- Annual examination by a urologist with ultrasound
Where are bladder stones removed in Tashkent
Endoscopic stone removal requires a cystoscopic stand, a lithotripter or laser, and the ability to simultaneously perform prostate surgery.
In Tashkent, contact and laser cystolithotripsy, as well as combined interventions with TUR of the prostate, are performed at the UROLOGIC COMPLEX medical center and at the Tashkent Medical Park clinic.
When making an appointment, it makes sense to immediately clarify whether the cause of urinary stasis will be eliminated at the same time - this will save you from having to repeat the operation. Clinic contacts are below on the page.
