What are Bladder Stones?

Bladder stones are the stones formed in the bladder, which are divided into primary bladder stones and secondary bladder stones. The former refers to the stones formed in the bladder, which are mostly caused by malnutrition and are more common in children. With the continuous development of China's economy, children's bladder stones have now shown a downward trend. The latter refers to bladder stones formed from factors such as upper urinary tract or secondary to lower urinary tract obstruction, infection, bladder foreign body or neurogenic bladder. In economically developed areas, bladder stones mainly occur in older men, and they are more likely to suffer from benign prostatic hyperplasia or urethral strictures. In poor areas, they are more common in children and rare in women.

Basic Information

English name

vesical calculus

Visiting department

Urology

Multiple groups

Older men

Common locations

bladder

Common causes

Malnutrition, urinary tract obstruction, infection, foreign body in the bladder, etc.

Common symptoms

Pain and hematuria

Causes of bladder stones

In addition to the factors of malnutrition, bladder stones, lower urinary tract obstructions such as benign prostatic hyperplasia, urethral strictures, and bladder neck tumors can be caused by lower urinary tract obstruction, infection, foreign body in the bladder, and metabolic diseases. Bladder stones. Foreign bodies in the bladder, such as catheters and sutures, can be used as the core to form secondary bladder stones. In addition, bladder stones with worm eggs as the core can be seen in the endemic area of schistosomiasis in Egypt.

Clinical manifestations of bladder stones

The main symptoms are pain and hematuria. The degree is related to the factors such as the location, size, activity, and complications of the stones.

Bladder stones

1. Plain radiographs of the bladder area can show the shadow of stones.

2.B-ultrasound can detect sound and shadow of bladder stones; cystoscopy can determine the presence or absence of stones, the size, shape, and number of stones, and can also detect negative stones with X-ray transmission and other lesions, such as cystitis, prostate Hyperplasia, bladder diverticulum, etc.

Bladder stones diagnosis

A preliminary diagnosis is often made based on typical symptoms. Attention should be paid to the etiology diagnosis. Larger bladder stones can be examined non-invasively by digital rectal examination and B-ultrasound, which can show stones and shadows. X-ray abdominal plain film can show most stones. Inserting a metal probe through the urethra may feel the stones, but it can only be applied in adults. There is a danger of urethra damage in children due to inability to cooperate. Cystoscopy is the most reliable way to diagnose bladder stones. Whether the stone is radiographed or not, the specific characteristics of the stone can be identified, and other lesions can be found, such as benign prostatic hyperplasia, bladder diverticula, inflammatory changes, and canceration.

Bladder stones treatment

The principle of treatment of bladder stones is to remove the stones and correct the cause of the stones. In severe bladder infections, antibiotics should be used.

Small stones can be excreted by the urethra. Intravesical lithotripsy can be performed for those who cannot excrete larger stones. The lithotripsy methods include extracorporeal shock wave lithotripsy and hydroelectric shock lithotripsy, ultrasonic rock and lithotripsy clamp lithotripsy. Large stones and no lithotripsy equipment can be used for suprapubic bladder incision and stone removal. In patients with bladder infection, inflammation should be actively treated at the same time.

There are many treatment methods for bladder stones, but there are generally two types, one is surgical stone removal, and the other is non-surgical lithotripsy. Among them, surgical stone extraction is the traditional suprapubic bladder incision stone extraction, and the other type of non-surgical lithotripsy can be divided into cystoscopy mechanical lithotripsy (powerful forceps lithotripsy), hydroelectric effect lithotripsy, ultrasonic lithotripsy, ballistic Pneumatic lithotripsy. There are four main methods:

1. Extracorporeal shock wave lithotripsy (ESWL) bladder lithotripsy method

After the patient has emptied the bladder, 100 ml of normal saline is injected into the bladder. If the urine in the bladder cannot be drained, part of the urine can be retained, the prone position is taken, and the fixed device is removed after lithotripsy. Let the patient move left and right, observe the crushing situation, crushed stone particles <0.5cm. Three days after the operation, intramuscular furosemide was injected 20 mg twice daily, and the amount of water was increased. Oral antibiotics were administered orally for 1 week.

2. Cystoscopy vigorous lithotripsy method

After successful ramie lithotripsy, inject 5ml paraffin oil into the urethra, crush the stones under the direct view of 24F bladder lithotripsy forceps, and repeat the operation until the lithotripsy can be completely washed out with a flusher.

3. Cystoscopy hydroelectric effect lithotripsy method

The method is the same as forcefully crushing the lithotripsy, except that the electrode should be more than 2cm away from the cystoscope during operation, and the electrode should be less than 0.5cm away from the stone, which can effectively lithotripsy and avoid damaging the cystoscope.

4. Upper pubic bladder incision and stone removal

After successful epidural anesthesia, incision was performed layer by layer until the bladder was cleared of stones, combined with severe infection, and the patient had a suprapubic cystostomy. This technique is a traditional open surgery method.