bladder calculus

Bladder Calculus: A Comprehensive Overview

Bladder calculus, also known as vesical calculus or cystoliths, refers to hard lumps of minerals that can form inside the bladder when it's not completely empty of urine [7]. These mineral deposits are a type of urinary stone that can cause discomfort and other symptoms.

Causes and Risk Factors

Bladder stones are most often caused by another urinary system problem, such as:

• Bladder diverticulum
• Blockage at the base of the bladder
• Urinary tract infection (UTI)
• Enlarged prostate
• Weakened bladder wall (cystocele)

These conditions can lead to concentrated urine and mineral buildup in the bladder [9].

Types of Bladder Stones

The most common types of bladder stones include:

• Uric acid stones: These are often hereditary and develop when uric acid levels are consistently high.
• Calcium oxalate stones: These form when there are high levels of calcium, oxalate, cystine, or phosphate and too little liquid.
• Struvite stones: These are composed of magnesium, ammonium, and phosphate.

Symptoms

Symptoms of bladder calculus may include:

• Suprapubic pain
• Urinary urgency and frequency
• Difficulty emptying the bladder

These symptoms can be severe and may require medical attention [13].

Prevalence and Treatment

Bladder stones are relatively rare in Western countries, but they can occur more frequently in developing countries due to dietary factors. Treatment options include medications or surgery to remove the stone.

In some cases, bladder augmentation surgery can increase the risk of bladder stones forming, with up to 53% of patients experiencing this complication [14].

Conclusion

Bladder calculus is a type of urinary stone that can cause discomfort and other symptoms. Understanding its causes, types, and treatment options is essential for effective management and prevention.

References:

[7] Bladder stones are hard lumps of minerals that can form inside the bladder when it's not completely empty of urine. [9] Causes. Bladder stones are most often caused by another urinary system problem, such as: Bladder diverticulum. Blockage at the base of the bladder. [13] Suprapubic pain along with urinary urgency and frequency suggests a distal ureteral, ureterovesical, or bladder calculus (see Symptoms and Signs of Obstructive Uropathy). [14] Bladder augmentation is a surgery that increases bladder capacity, and research indicates that bladder stones can occur in up to 53 percent of patients who have had this procedure done.

Symptoms of Bladder Calculus

Bladder calculus, also known as bladder stones, can cause a range of symptoms that may vary in severity. Some common signs and symptoms include:

• Severe pain: Abdominal pain or lower back pain can be severe and may radiate to the groin area [1].
• Difficulty peeing: Pain or difficulty when urinating is a common symptom, which can also lead to frequent urination [2][6].
• Frequent urination: Needing to urinate often, especially at night, can be a sign of bladder stones [3][7].
• Loss of urine control: Incontinence or loss of urine control may occur with bladder stones [4][8].
• Blood in urine: A urine sample might be tested for signs of blood, which can indicate the presence of bladder stones [5].

Other symptoms

In addition to these common symptoms, other signs and symptoms may include:

• Abdominal pain or pressure
• Pain or discomfort in the penis (in men)
• Signs of urinary tract infection (UTI), such as fever, pain when urinating, and frequent urination

It's essential to seek medical attention if you experience any of these symptoms, especially severe pain or difficulty peeing. A healthcare professional can diagnose bladder stones through a physical examination, imaging tests, and urine analysis.

References:

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Here are some diagnostic tests for bladder calculus (bladder stones):

1. Urinalysis: A urine test to check for bacteria, blood, and other minerals that may indicate the presence of a stone.
2. Imaging tests:
   • CT scan: Computed Tomography scan to visualize the bladder and surrounding tissues.
   • Ultrasound: To examine the bladder and detect any stones or abnormalities.
   • X-ray: To check for calcifications in the bladder.
3. Intravenous Pyelogram (IVP): A contrast dye is injected into a vein, and X-rays are taken to visualize the urinary tract and detect any blockages or stones.
4. Cystoscopy: A flexible tube with a camera is inserted through the urethra to visually examine the bladder and detect any stones or abnormalities.
5. Urodynamic tests: To assess the function of the bladder and urethra, which can help diagnose conditions that may contribute to stone formation.

These diagnostic tests can help identify bladder calculus and rule out other conditions that may be causing similar symptoms.

Treatment Options for Bladder Stones

Bladder stones, also known as bladder calculi, are hard buildups of mineral that form in the urinary bladder. While there are various treatment options available, drug treatment is rarely used to dissolve the stones.

• Medications: Drugs such as alpha-blockers and nonsteroidal anti-inflammatory drugs (NSAIDs) may be prescribed to help relieve pain and discomfort associated with bladder stones [3][9].
• Pain Relief: NSAIDs can help alleviate pain caused by bladder stones, but not everyone can take these medications [3].
• Dissolving Stones: Medications are rarely used to dissolve the stones. Instead, treatment focuses on removing the stone or addressing the underlying cause of the bladder stone [7][14].

Important Consideration

It's essential to note that causes of bladder stones should be treated. Most commonly, bladder stones are seen with Benign Prostatic Hyperplasia (BPH) or blockage at the base of the urinary tract [7][14]. Addressing these underlying issues is crucial in preventing future occurrences.

References:

• [3] Bladder stones can cause pain, difficulty peeing, bleeding and infection. Talk to your provider if you have a condition — such as BPH — that increases your chances of developing bladder stones.
• [7] Drugs are rarely used to dissolve the stones. Causes of bladder stones should be treated. Most commonly, bladder stones are seen with BPH or blockage at the base of the urinary tract.
• [9] Any surgical procedure comes with some risks, so cystolitholapaxy is always the first choice when possible.
• [14] A laser or other device will be used to break up the stones and the pieces will be removed. Some stones may need to be removed using open surgery. Medicines are rarely used to dissolve the stones.

The differential diagnosis for bladder calculus includes:

1. Bladder diverticula: Pockets or cave-like openings in the bladder wall that can hold urine and cause symptoms similar to bladder stones.
2. Urachal cysts: Congenital anomalies that can form a cystic structure connected to the bladder, which may contain calculi.
3. Ureterovesical junction (UVJ) obstruction: Blockage at the junction of the ureter and bladder, which can cause urine to back up into the ureter and form stones.
4. Neurogenic bladder: A condition where the nerves controlling the bladder are damaged, leading to urinary retention and potential stone formation.
5. Cystocele: A condition where the bladder prolapses into the vagina, which can cause symptoms similar to bladder stones.
6. Urethral stricture: A narrowing of the urethra that can cause urine to back up into the bladder and form stones.
7. Prostatic obstruction: Enlargement of the prostate gland that can block the flow of urine and lead to stone formation in the bladder.
8. Urachal carcinoma: A rare type of cancer that can occur in the urachus, a congenital anomaly that connects the bladder to the navel.
9. Leiomyosarcoma: A rare type of cancer that can occur in the smooth muscle of the bladder wall and cause symptoms similar to bladder stones.

These conditions should be considered in the differential diagnosis for bladder calculus, especially if the patient presents with symptoms such as hematuria, dysuria, or urinary retention.