BLADDER STONES CAUSES AND DIAGNOSIS

Bladder stones are small mineral masses that develop in the bladder, usually when the urine becomes concentrated. Urolithiasis refers to stones in any part of the urinary tract, including the kidneys, bladder or urethra. The stones can be called calculi. Spinal cord injuries that result in urinary incontinence, an enlarged prostate, or recurring urinary tract infections are common causes of concentrated and stagnant urine. If urine remains too long in the bladder, urine chemicals start clumping together, forming crystals which grow and eventually develop into bladder stones.

Bladder stones used to be much more common in the UK, USA and other developed countries, when people's diets lacked a good balance of carbohydrates and proteins. Today, however, most patients in industrialized nations with bladder stones have an underlying bladder problem.

Sometimes, patients with bladder stones first know about it after tests for other problems reveal them - they may exist without any symptoms. Signs and symptoms of bladder stones may include abdominal pain, pain when urinating, or blood in urine.

A tiny bladder stone may pass out of the body on its own. However, larger ones require medical intervention to get them out. Untreated bladder stones can eventually result in infections and complications.

CAUSES

Bladder stones generally begin when your bladder doesn't empty completely. The urine that's left in your bladder can form crystals that eventually become bladder stones. In most cases, an underlying condition affects your bladder's ability to empty completely.

THE MOST COMMON CONDITIONS THAT CAUSE BLADDER STONES INCLUDE:

Prostate Gland Enlargement: An enlarged prostate, or benign prostatic hyperplasia (BPH), can cause bladder stones in men. As the prostate enlarges, it can compress the urethra and interrupt urine flow, causing urine to remain in your bladder.

DAMAGED NERVES (neurogenic bladder): Normally, nerves carry messages from your brain to your bladder muscles, directing your bladder muscles to tighten or release. If these nerves are damaged — from a stroke, spinal cord injury or other health problem — your bladder may not empty completely.
Other conditions that can cause bladder stones include:

Inflammation: Bladder stones can develop if your bladder becomes inflamed. Urinary tract infections and radiation therapy to your pelvic area can both cause bladder inflammation.

Medical devices: Occasionally, bladder catheters — slender tubes inserted through the urethra to help urine drain from your bladder — can cause bladder stones. So can objects that accidentally migrate to your bladder, such as a contraceptive device or stent. Mineral crystals, which later become stones, tend to form on the surface of these devices.

Kidney Stones: Stones that form in your kidneys are not the same as bladder stones. They develop in different ways and often for different reasons. But small kidney stones occasionally travel down the urethras into your bladder and, if not expelled, can grow into bladder stones.

DIAGNOSING BLADDER STONES

A GP (general practitioner, primary care physician), often the first health care professional the sufferer will go to, will interview the patient and carry out a physical exam. The doctor will feel the lower abdomen to determine whether there is any bladder distention (swelling). If the individual is male a rectal exam may be done, to check the size of the prostate.

If the GP suspects there may be bladder stones, the patient will be referred to a hospital for tests, which may include:

Urine test (urinalysis) - a urine sample is examined for blood, bacteria and crystallization of minerals.

Cystoscopy - a cystoscope, a slender tube with a tiny camera at the end is inserted through the urethra and into the bladder. Water flows through the cystoscope into the bladder, filling it up. This stretches the bladder wall so that the doctor can see the inside of it more clearly. With a cystoscope the doctor can determine whether there are any bladder stones, how many there are, what they are like, and where exactly they all are.

Spiral CT (computerized tomography) scan - the CT scanner uses digital geometry processing to generate a 3-dimensional (3-D) image of the inside of an object. The 3-D image is made after many 2-dimensional (2-D) X-ray images are taken around a single axis of rotation - in other words, many pictures of the same area are taken from many angles and then placed together to produce a 3-D image. It is a painless procedure. A spiral CT scans more rapidly and with greater definition - even tiny stones can be detected. This is considered the most sensitive test for detecting all types of bladder stones.

Ultrasound scan - this device uses ultrasound waves which bounce off tissues; the echoes are converted into a sonogram (an image) which the doctor can see on a monitor. The doctor can get an inside view of soft tissues and body cavities; which in this case would be the bladder and inside the bladder.

X-ray - may be used to determine whether there are stones anywhere in the urinary system, including the kidneys, ureters and bladder. X-rays may not detect all types of stones.

Intravenous pyelogram (intravenous urogram) - a dye is injected into a vein in the arm. The dye flows into the kidneys, ureters and bladder, which are revealed in X-ray images. Several X-rays are taken, at specific points in time.

WHAT ARE THE TREATMENT OPTIONS FOR BLADDER STONES?

Bladder stones should not remain in the bladder. Small ones may usually be flushed out by drinking more water - at least 6 to 8 glasses (1.2 liters) of water a day. Patients should be guided by what their doctor tells them.

If the bladder stone is too large to be flushed out on its own, the doctor may need to remove it through surgery.