Medicines for Bladder stones

What it is

Bladder stones are hard lumps of minerals that form in the bladder. They develop when urine stays in the bladder and becomes concentrated, allowing minerals to crystallise and form stones — so they are often associated with the bladder not emptying completely. Common underlying causes and risk factors include: an enlarged prostate (in men), which can obstruct the flow of urine and prevent full emptying; other causes of a blocked or poorly emptying bladder; nerve problems affecting the bladder (a "neurogenic bladder"); long-term urinary catheters; and recurrent urinary infections. Bladder stones are more common in older men, largely because of the link with prostate enlargement. Small bladder stones may cause no symptoms and can sometimes pass out in the urine on their own. Larger stones, or stones that irritate the bladder or block the flow of urine, can cause symptoms, which may include: pain in the lower tummy; pain, difficulty, or interruption when passing urine; needing to urinate more often or urgently, including at night; blood in the urine; cloudy or dark urine; and, in men, sometimes pain in the penis. Bladder stones can also lead to complications such as urinary infections or, if they block the flow of urine, more significant problems. Because bladder stones usually form because of an underlying problem (such as a bladder that does not empty properly), treatment involves both dealing with the stones and addressing the underlying cause to prevent them recurring. Bladder stones are usually treated by removing them or breaking them up — commonly through a procedure passed into the bladder (rather than open surgery in most cases) — and the underlying cause (such as an enlarged prostate) is treated. The key messages are that bladder stones often form when the bladder does not empty fully, that they cause tummy and urinary symptoms, and that treatment involves removing or breaking up the stones and addressing the underlying cause.

How it is treated

Bladder stones are usually treated by removing or breaking up the stones and by addressing the underlying cause (such as a poorly emptying bladder) to prevent them coming back. If bladder stones are suspected — from symptoms such as lower tummy pain, urinary symptoms (difficulty or interruption passing urine, needing to go more often or urgently, blood in the urine), or in the context of an enlarged prostate or a poorly emptying bladder — assessment is arranged, which may include urine tests, and scans or a look inside the bladder (cystoscopy) to confirm the stones and assess the bladder. The main treatment is to deal with the stones, and this is usually done through a procedure rather than open surgery: commonly, a thin instrument is passed into the bladder (through the urethra), and the stones are broken up (for example with a laser or other energy) and the fragments removed or flushed out; occasionally, for very large stones, other approaches (including surgery) are used. Small stones causing no symptoms may sometimes pass on their own or be managed conservatively, but larger or symptomatic stones are usually treated. Crucially, because bladder stones usually form because of an underlying problem, treating the underlying cause is an important part of management to prevent recurrence — for example treating an enlarged prostate or other cause of poor bladder emptying, managing a neurogenic bladder, addressing recurrent infections, or reviewing catheter care. Any associated urinary infection is treated. Drinking enough fluids helps keep the urine less concentrated. Because bladder stones can recur if the underlying problem is not addressed, follow-up and managing the cause are important. It is worth seeing a GP about persistent lower tummy or urinary symptoms, blood in the urine (which always needs assessment), or difficulty passing urine, so the cause can be investigated. The reassuring messages are that bladder stones are usually treatable by removing or breaking them up (commonly without open surgery), and that addressing the underlying cause (such as a poorly emptying bladder) treats the symptoms and helps prevent the stones from recurring.