Calcium stones (calculi) are hard crystalline masses that form in the urinary tract. Bladder stones are much less common than kidney stones and occur in men 95 percent of the time. They can cause pain, bleeding, infection, and blocked urine flow. Expert advice from reputable sources including the National Center for Biotechnology Informationand Merck, a leading research-driven healthcare company, can help you manage this condition and avoid its recurrence.
Depending on where a stone forms, it may be a kidney, ureteral, or bladder stone. Each stone begins to develop at about the size of grains of sand. Stones vary in size from too small for the naked eye to see, to one inch or more in diameter. Minerals and proteins that occur naturally in your urine form crystals, which can grow into stones.
About 85 percent of stones are composed of calcium. The remainder consist of various substances including uric acid, cystine (an amino acid), and struvite (a hydrous phosphate of magnesia and ammonia). Infection or struvite stones contain a mixture of magnesium, ammonium, and phosphate and form only in infected urine.
Bladder stones begin generally when your bladder doesn’t empty completely. Your remaining urine can form crystals that can become bladder stones eventually. The most common causes are underlying urinary system problems such as:
Urinary tract infections (UTIs) that cause inflammation
Bladder outlet obstruction: blockage that reduces or prevents urine flow from your bladder into your urethra
Diverticulum: small pouch or sac that bulges out from the bladder wall
Foreign bodies in your urinary tract
Neurogenic bladder: diabetes, stroke, Parkinson’s disease, a spinal cord injury, nerve condition, and other medical problems can damage the nerves that control bladder function
Stones may occur when urine in the bladder is concentrated and salts or foreign objects form crystals. Or your urine may lack the normal inhibitors that prevent stone formation. Citrate is an inhibitor that binds with calcium.
Certain disorders like hyperparathyroidism, dehydration, renal tubular acidosis, and gout
A diet that’s very high in animal-source protein or vitamin C
Not consuming enough water or calcium
Family history of stone formation
Previous bariatric weight-loss surgery
Substances in the diet such as melamine
Tiny bladder stones may not be bothersome, but larger ones can cause severe symptoms. When stones irritate the lining of your bladder or block your urine flow, you may experience:
Lower abdominal pain and/or pressure
Concentrated, stagnant,cloudy, or abnormally dark-colored urine
Blood in your urine
Frequent urges to urinate
Inability to urinate except in certain positions
Urine stream interruption
Pain or discomfort in your penis
Signs of urinary tract infection such as fever, pain when urinating, and needing to urinate more often
Urinary incontinence or an inability to control urination
Bladder stones may cause pain in your lower abdomen. Ones that obstruct your ureter, renal pelvis, or any of your kidney’s drainage tubes may trigger back pain. Or you may develop renal colic with excruciating intermittent pain, usually between your ribs and hips that spreads across your abdomen and extends to your genital area and inner thighs. The pain tends to come in waves, increasing gradually to peak intensity and then fading over about 20 to 60 minutes.
A urinary tract infection may result if urine that pools above a blockage traps bacteria. When stones block your urinary tract for a long time, urine backs up in the tubes inside your kidneys, causing excessive pressure that can distend and damage your kidneys eventually.
Your doctor will perform a physical examination including a rectal exam that may reveal an enlarged prostate or other problems. Tests that diagnose stones include:
Bladder or pelvic x-ray
Cystoscope: a small telescope that examines your bladder and urethra linings
If your doctor prescribes Flomax (Tamsulosin), this alpha-blocker will relax your prostate and bladder muscles to improve urine flow. Also drinking 48 to 64 ounces of water per day to increase urine output may encourage small stones to pass.
Further medical treatment may be necessary if stones don’t pass after two weeks or your symptoms worsen. Using ultrasound, your doctor may break up stones into smaller pieces that you can pass more easily. Or your doctor may perform a cystolitholapaxy to remove stubborn stones with a cystoscope. Some stones may need removal by open surgery.
The passing or removal of most bladder stones doesn’t cause permanent bladder damage. However, most stones arise from underlying medical conditions. If you have benign prostatic hyperplasia (BPH or enlarged prostate) and bladder stones, you may need a transurethral resection of the prostate (TURP), which your doctor can perform along with stone removal.
When patients don’t correct bladder stone causes, recurrences afflict approximately half of patients within five years. Untreated stones may result in repeated urinary tract infections, chronic bladder dysfunction, or permanent damage to your bladder or kidneys.
Prompt treatment of BPH, UTIs, bladder outlet obstruction, and other urinary tract conditions may help prevent future bladder stones. Doctors also recommend drinking plenty of fluids, especially water, per day to dilute the concentration of minerals in your bladder.