Diagnosis

Diagnosing bladder stones may involve:

  • A physical exam. Your doctor will likely feel your lower abdomen to see if your bladder is enlarged (distended) or may perform a rectal exam to determine whether your prostate is enlarged. You'll also discuss any urinary signs or symptoms that you're having.
  • Analysis of your urine (urinalysis). A sample of your urine may be collected and examined for microscopic amounts of blood, bacteria and crystallized minerals. A urinalysis also helps determine whether you have a urinary tract infection, which can cause or be the result of bladder stones.
  • Computerized tomography (CT). CT uses X-rays and computers to quickly scan and provide clear images of the inside of your body. CT can detect even very small stones and is considered one of the most sensitive tests for identifying all types of bladder stones.
  • Ultrasound. An ultrasound, which bounces sound waves off organs and structures in your body to create pictures, can help your doctor detect bladder stones.
  • X-ray. An X-ray of your kidneys, ureters and bladder helps your doctor determine whether stones are present in your urinary system. But some types of stones aren't visible on conventional X-rays.

Treatment

Bladder stones generally need to be removed. Your doctor may recommend drinking a lot of water each day to help a small stone pass naturally. However, because bladder stones are often caused by the inability to empty the bladder completely, this may not be enough to make the stone pass. Most cases require removal of the stones.

Breaking stones apart

Bladder stones are often removed during a procedure called a cystolitholapaxy (sis-toe-lih-THOL-uh-pak-see). A small tube with a camera at the end (cystoscope) is inserted through your urethra and into your bladder to view the stone. Your doctor then uses a laser, ultrasound or mechanical device to break the stone into small pieces and flushes the pieces from your bladder.

Hand-held lithotripters use ultrasonic energy to break up the stone into pieces small enough to pass in the urine. Holmium laser lithotripsy uses a laser to break up the stone.

Before the procedure, you'll likely be given an anesthetic that numbs the lower part of your body (regional anesthesia) or that makes you unconscious and unable to feel pain (general anesthesia). Complications from a cystolitholapaxy aren't common, but urinary tract infections, fever, a tear in your bladder or bleeding can occur. Your doctor may give you antibiotics before and after the procedure to reduce the risk of infections.

About a month after the cystolitholapaxy, your doctor will likely confirm that there are no remaining stone fragments in your bladder.

Surgical removal

Occasionally, bladder stones that are large or too hard to break up are removed through surgery. In these cases, your doctor makes an incision in your bladder and directly removes the stones.

Alternative medicine

No studies have confirmed that herbal remedies can break up bladder stones, which are extremely hard and usually require a laser, ultrasound or other procedure for removal.

Always check with your doctor before taking any alternative medicine therapy to be sure it's safe and that it won't adversely interact with other medications you're taking.

Preparing for your appointment

If you have signs and symptoms of bladder stones, you're likely to start by seeing your family doctor or a general practitioner. However, you may be referred to a doctor who specializes in treating disorders of the urinary tract (urologist).

What you can do

To get ready for your appointment, make a list of:

  • Any symptoms you're experiencing, including any that may seem unrelated to your condition
  • Key personal information, including any major stresses or recent life changes
  • All medications you're taking, as well as any vitamins or other supplements
  • Questions to ask your doctor, in order of importance

In addition:

  • Be aware of any pre-appointment restrictions. Ask if there's anything you need to do in advance, such as restrict your diet.
  • Ask a family member or friend to come with you. Someone who accompanies you may remember information that you missed or forgot.

For bladder stones, some basic questions to ask your doctor include:

  • Can bladder stones pass without treatment?
  • If not, do they need to be removed, and what's the best method?
  • What are the risks of the treatment you're proposing?
  • What will happen if the stones aren't removed?
  • Is there any medication I can take to eliminate bladder stones?
  • How can I keep them from coming back?
  • I have other health conditions. How can I best manage these conditions together?
  • Are there any dietary restrictions that I need to follow?
  • Will the stones come back?
  • Do you have any printed materials that I can have? What websites do you recommend?

Don't hesitate to ask additional questions that may come up during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

  • When did you begin experiencing symptoms?
  • Have your symptoms been continuous or occasional?
  • How severe are your symptoms?
  • Have you had a fever or chills?
  • Does anything seem to improve your symptoms?
  • What, if anything, appears to worsen your symptoms?
Oct. 27, 2016
References
  1. McAninch JW, et al. Urinary stone disease. In: Smith & Tanagho's General Urology. 18th ed. New York, N.Y.: The McGraw-Hill Companies; 2013. http://www.accessmedicine.com. Accessed June 21, 2016.
  2. Urinary calculi. Merck Manual Professional Version. http://www.merckmanuals.com/professional/genitourinary_disorders/urinary_calculi/urinary_calculi.html. Accessed June 21, 2016.
  3. What are kidney stones? American Urological Association. http://www.urologyhealth.org/urologic-conditions/kidney-stones. Accessed June 21, 2016.
  4. Tintinalli JE, et al. Urologic stone disease. In: Tintinalli's Emergency Medicine: A Comprehensive Study Guide. 7th ed. New York, N.Y.: The McGraw Hill Companies; 2011. http://www.accessmedicine.com. Accessed June 21, 2016.
  5. Wein AJ, et al., eds. Lower urinary tract calculi. In: Campbell-Walsh Urology. 11th ed. Philadelphia, Pa.: Elsevier; 2016. http://www.clinicalkey.com. Accessed June 21, 2016.
  6. Kidney and ureteral stones: Surgical management. American Urological Association. http://www.urologyhealth.org/urology/index.cfm?article=32. Accessed June 21, 2016.
  7. Curhan GC, et al. Diagnosis and acute management of suspected nephrolithiasis in adults. http://www.uptodate.com/home. Accessed June 21, 2016.
  8. Rakel D. Urolithiasis. In: Integrative Medicine. 3rd ed. Philadelphia, Pa.: Saunders Elsevier; 2012. http://www.clinicalkey.com. Accessed June 21, 2016.
  9. What are the signs of kidney stones? American Urological Association. http://www.urologyhealth.org/urologic-conditions/kidney-stones/symptoms. Accessed June 21, 2016.
  10. Humphreys MR (expert opinion). Mayo Clinic, Phoenix, Ariz. June 30, 2016.
  11. Stones in the urinary tract. Merck Manual Consumer Version. http://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/stones-in-the-urinary-tract/stones-in-the-urinary-tract. Accessed June 21, 2016.