Bladder Stones (Bladder Calculi)
What are bladder stones?
Bladder stones form when minerals in urine (pee) crystalize and clump together in the bladder. The medical term for bladder stones is bladder calculi.
Bladder stones generally develop when some urine stays in the bladder after you pee. Without treatment, stones can cause infections, bleeding and long-term problems in the urinary tract.
Who is likely to get bladder stones?
Anyone can get bladder stones, but men over 50 are more likely to develop them. Around half of men over 50 have a condition called benign prostatic hyperplasia (BPH). BPH causes the prostate (an organ located below the bladder in men) to get bigger. An enlarged prostate can make it difficult to drain the bladder. Stones can form when urine sits in the bladder for too long.
People who have nerve damage such as a spinal cord injury affecting the bladder are more likely to get bladder stones. Also, individuals who have had specific types of surgery on their bladder (such as enlargement of the bladder with intestine) are also at risk of bladder stones. Very rarely, a bladder stone will be the result of a kidney stone that could not pass out of the bladder. This can occur in people who have difficulty draining urine out of their bladder, such as men with BPH.
Symptoms and Causes
What are the symptoms of bladder stones?
Some bladder stones pass out of the body with urine and don’t cause any symptoms. Large bladder stones can irritate the bladder and cause severe pain, bleeding, and problems urinating. Signs and symptoms include:
- Changes in urine color: You may have cloudy or dark urine, or you may see blood in your urine.
- Frequent need to urinate: You may feel like you always need to pee, even if you just went.
- Pain: With bladder stones, it’s common to feel pain or burning when urinating. You may also feel pain that comes and goes in the lower part of the abdomen (belly). Men sometimes feel pain in the penis or testicles.
- Stopping and starting: You may have a difficult time starting the flow of urine, even if you really have to go. Sometimes the urine stream stops and starts (urinary intermittency).
- Urinary tract infections: Bladder stones can lead to infections of the urinary tract (UTIs). UTI symptoms include frequent, painful urination as well as cloudy, smelly urine.
What causes bladder stones?
Bladder stones form when urine sits in the bladder too long. The bladder is part of the body’s urinary system. When urine stays too long in the bladder, it becomes concentrated. Minerals in the urine harden and form crystals that clump together.
This process happens when you aren’t able to empty the bladder completely. Several conditions and factors increase the risk of bladder stones, including:
- Augmentation cystoplasty: During an augmentation cystoplasty (bladder augmentation) procedure, providers use tissue from the bowel to make the bladder larger and improve the way it works. Sometimes the procedure can cause pee to pool in the bladder.
- Bladder diverticula: Pouches or pockets in the bladder make it hard to empty the bladder completely. This condition can occur at birth or it can develop later in life as a result of disease or an enlarged prostate.
- Dehydration: Water dilutes the minerals in urine and flushes out the bladder. Dehydration (not drinking enough fluids) can lead to bladder stones because minerals build up in concentrated urine.
- Enlarged prostate: The prostate can get bigger as men age, which puts pressure on the urethra (the tube that carries pee from the kidneys to the bladder). The extra pressure can make it difficult to empty the bladder completely.
- Fallen bladder: Some women develop a condition called cystocele after childbirth. Weakened walls of the bladder fall into the vagina and block the flow of urine.
- Kidney stones: Bladder stones are similar to kidney stones. Sometimes a kidney stone can travel from your kidney into your bladder. Usually if the stone can pass into the bladder, it can easily be urinated out of the bladder. Very rarely, in patients who have trouble urinating, the stone can get stuck and get bigger inside the bladder and cause pain and difficulty urinating.
- Neurogenic bladder: Nerve damage from a spinal cord injury, stroke, other disease disease or congenital abnormality (such as spina bifida) can affect how the bladder works. People with neurogenic bladder often need a catheter (a thin, flexible tube) to drain the bladder. Sometimes catheters can’t drain all of the urine.
- Medical devices. Patients with devices in the bladder, such as catheters, can develop bladder stones from crystals that form on the device. This is typically if the device has been in the body longer than the recommended time periods.
Diagnosis and Tests
How are bladder stones diagnosed?
Your provider will examine you and ask about your symptoms. To diagnose bladder stones, your provider may order:
- Urine test: Your provider sends a sample of your urine to a lab to check for small bladder stones. The lab will also test your urine for signs of a urinary tract infection or blood.
- Imaging tests: Computed tomography (CT) scans, X-ray and ultrasound images allow your provider to see clear pictures of your bladder. These tests show the size, shape and location of bladder stones.
- Cystoscopy: During this procedure, your provider uses a small scope to look inside your bladder and check for stones. The scope is thin and flexible, with a camera on the end.
Management and Treatment
What is the treatment for bladder stones?
Typically, bladder stones need to be removed from the bladder by a urologist. Very rarely, they can be dissolved but this depends on the type of stone you have and can also take a long time.
Treatment for bladder stones includes:
- Cystolitholapaxy: During a cystolitholapaxy, providers use a scope to visualize the stones in the bladder and then break bladder stones into tiny pieces using lasers or ultrasound (high-frequency sound waves). The pieces are then removed from the bladder.
- Surgery: If the stones are especially large, you may need open surgery to remove them. Your provider makes an incision in your abdomen and takes out the stones.
Can I prevent bladder stones?
It may not be possible to prevent bladder stones, but you can lower your risk by drinking plenty of water. Water dilutes minerals in your urine, so they’re less likely to clump together and form stones. Ask your healthcare provider how much water you should drink every day.
Talk to your provider if you’re a man over age 50, especially if you have an enlarged prostate. Your provider may recommend specific techniques or medications to help you empty your bladder.
For patients with certain types of stones, modifying your diet or using specific medications based on the stone type, may help reduce future stones.
Outlook / Prognosis
What is the outlook for people who have bladder stones?
Some small bladder stones may pass out of the body without treatment. But for the majority that don’t pass on their own, providers can remove them with minimally invasive procedures or surgery. With proper treatment, bladder stones don’t cause long-term health problems.
Untreated bladder stones can lead to pain, difficulty urinating, bleeding and infection. Talk to your provider if you have a health condition (such as BPH) that can lead to bladder stones. If you don’t treat the cause, bladder stones may form again.
When should I see my healthcare provider about bladder stones?
If you have any signs of bladder stones, talk to your provider. Stones continue to grow when they remain in the bladder. That’s why it’s important to get treated as soon as you notice symptoms.
Without treatment, bladder stones can lead to health problems like frequent urinary tract infections. Repeated UTIs can damage the urinary tract.
A note from Cleveland Clinic
If you have signs of bladder stones, be open and honest with your healthcare provider. Effective treatments are available if the stones are too big to pass. It’s important to get treated as early as possible and address any health conditions that may be causing bladder stones. Early treatment can relieve symptoms, help you avoid long-term damage and keep bladder stones from developing again.
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