Table of contents
Bladder stones
What's new
Updated 2024 EAU guidelines for the diagnosis and management of bladder stones.
Background
Overview
Definition
Bladder stones are hard mineral deposits that form in the bladder.
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Pathophysiology
The pathophysiology of bladder stone formation involves supersaturation of urine with stone-forming substances, such as calcium, oxalate, or uric acid. This leads to nucleation, where these substances begin to aggregate and form crystals. Over time, these crystals grow into larger stones.
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Epidemiology
The incidence of bladder stones is higher in developing countries, with an estimated rate of 8.3 per 100,000 person-years in Indonesia. The incidence of bladder stones after bladder augmentation or vesicoenterocystostomy is estimated at 2-53%.
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Risk factors
Risk factors for bladder stone formation include urinary stasis, prostate enlargement, UTIs, spinal cord injury, and certain bladder procedures such as bladder augmentation or vesicoenterocystostomy.
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Disease course
Clinically, bladder stones can present with a variety of symptoms, including hematuria, lower abdominal pain, and difficulties with urination, such as dysuria, urinary frequency, urgency, or incontinence. In some cases, bladder stones may also cause acute urinary retention.
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Prognosis and risk of recurrence
The prognosis of bladder stones is generally good with appropriate treatment, but they can lead to complications if left untreated.
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Guidelines
Key sources
The following summarized guidelines for the evaluation and management of bladder stones are prepared by our editorial team based on guidelines from the European Association of Urology (EAU 2024).
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Diagnostic investigations
Medical management
Therapeutic procedures
Transurethral cystolithotripsy
As per EAU 2024 guidelines:
Offer transurethral cystolithotripsy in adult patients with bladder stones, where possible.
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Perform transurethral cystolithotripsy with a continuous flow instrument (such as nephroscope or resectoscope) in adult patients, where possible.
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More topics in this section
Percutaneous cystolithotripsy
Shock wave lithotripsy
Procedures for bladder outlet obstruction
Surgical interventions
Specific circumstances
Preventative measures
Prevention of stone recurrence: as per EAU 2024 guidelines, offer regular irrigation therapy with saline solution to reduce the risk of stone recurrence in adult and pediatric patients with bladder augmentation, continent cutaneous urinary reservoir or neuropathic bladder dysfunction and no history of autonomic dysreflexia.
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