Stone may form inside the bladder or get deposited in the bladder and grow to enormous sizes. Many times they may lead to symptoms like difficulty in passing urine, blood in urine, pain in the lower abdomen, retention of urine and severe burning in passing urine. Bladder Stone or Vesical calculus needs to be managed essentially by surgery. This surgery is done either without any cut or with a very small cut and is the most effective way of management of these stones.
How does bladder stone form ?
Bladder stone may form in two ways. Most commonly the stone forms in the kidney and pass from the ureter or the urine pipe of the kidney into the urinary bladder. In the bladder these stones grow and become large enough to cause an obstruction to the flow of urine thereby producing symptoms. Stones can also start to develop in the bladder because of severe obstruction or blockage in the flow of urine. This can happen because of an enlarged prostate, contracture of the bladder neck or a stricture or narrowing in the urethra.
What are the symptoms of Bladder Stone ?
Bladder stone can cause the following symptoms:
- Pain in the lower abdomen
- Straining to pass urine
- Recurrent urge to pass urine
- Increase in frequency
- Getting up many times in the night to pass urine
- Blood in urine
- Pain or burning while passing urine
- Difficulty in emptying the bladder completely
- Feeling of incomplete emptying of the bladder
- Retention of urine or inability to pass urine
How are Bladder stones treated ?
Very small bladder stones of less than 10mm may be treated with medicines that open the urethral passage and dissolve the stone. However larger stones need to be removed by surgery. There are various surgeries available for the management of Bladder Stones. These include the minimally invasive Cystolithotripsy, the small incision Percutaneous Cystolithotripsy and the conventional Cystolithotripsy.
| Cystolithotripsy Endoscopic scarless surgery done through the urinary passage itself | Percutaneous Cystolithotripsy Endoscopic Surgery done through the lower abdomen after making a 6 to 8 mm cut in the lower abdomen | Cystolithotomy Conventional open surgery done through a cut in the lower abdomen which is usually 4 to 5 cms |
| Applicable for Stones upto 2 cm | Applicable for stones up to 4 cms | Can be done for stones of any size |
| Duration of surgery is 1 hour | Duration of Surgery is 30 minutes to 3 hours depending size of stone | Duration of surgery is 1 hours irrespective of size of the stone |
| No cut or incision is made | 1 cm cut or incision is made over the lower abdomen | 4-10 cm incision is made in the lower abdomen depending on the size of stone |
| Stone is extracted in pieces | Stone is extracted in large pieces | Entire stone is extracted in toto |
| Recovery time is 24 hours | Recovery time is 48 hours | Recovery time is 48 hours |
| Catheter is kept after surgery for 24 hours | Catheter is kept after surgery for 7 to 10 days | Catheter is kept after surgery for 10-14 days |
| Minimal Complications like mild hematuria | Mild complications like hematuria and infection |
What are the complications of surgery for bladder stone ?
Bladder stone surgery can be associated with complications like:
- Persistent Hematuria or bleeding in urine
- Infection
- Urethral Stricture or narrowing of the urine pipe
- Bladder rupture
- Vesico cutaneous fistula
The complications are very rare and can be managed with medication or further surgery.
How to prevent recurrence of bladder stone?
There are many cases who undergo surgery for the bladder stones but the main reason behind the stones is never addressed. Stones form in an obstructed system and it si important to assess where the obstruction is. Usually patients have an enlarged prostate or a urethral stricture which can be managed along with removal of the bladder stone.
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