Bladder stones : Treatment

Surgery will usually be needed to remove bladder stones.

It may be possible to flush small bladder stones out of your bladder by drinking lots of water, but this may not work if you can't completely empty your bladder of urine.


Transurethral cystolitholapaxy

A transurethral cystolitholapaxy is the most common procedure used to treat adults with bladder stones.

The surgeon inserts a small, rigid tube with a camera at the end (a cystoscope) into your urethra and up into your bladder. The camera is used to help locate the bladder stones.

A crushing device, lasers or ultrasound waves transmitted from the cystoscope can be used to break up the stones into smaller fragments, which can be washed out of your bladder with fluids.

A transurethral cystolitholapaxy is carried out under either a local anaesthetic or a general anaesthetic, so you shouldn't feel any pain during the procedure.

There's a risk of developing an infection during the procedure, so you may be given antibiotics as a precaution. There's also a small risk of injury to the bladder.

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Percutaneous suprapubic cystolitholapaxy

A percutaneous suprapubic cystolitholapaxy is mainly used to treat children to avoid damaging their urethra. It's also sometimes used for adults with large bladder stones.

Instead of inserting a tube into the urethra, the surgeon makes a small cut in the skin of the lower abdomen.

Another cut is then made in the bladder so the stones can be removed. This will be done using a general anaesthetic.

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Open cystostomy

An open cystostomy is often used to remove bladder stones in men with a very large prostate, or if the stone itself is very large. 

It's a similar procedure to percutaneous suprapubic cystolitholapaxy, except the surgeon makes a much larger cut in the abdomen and bladder.

It may be combined with other types of surgery, such as removing some or all of the prostate or bladder diverticula (pouches that develop in the lining of the bladder).

The disadvantage of an open cystostomy is that it causes more pain afterwards and has a longer recovery time than the other types of surgery. But an open cystostomy will be needed if the bladder stone is large.

You'll need to use a catheter for a day or two after the procedure.

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Complications of surgery

The most common complication of bladder stone surgery is infection of the bladder or urethra, known as a urinary tract infection (UTI).

UTIs affect about 1 in 10 people who have bladder surgery and can usually be treated with antibiotics.

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Recovery and follow-up

After having a transurethral cystolitholapaxy or percutaneous suprapubic cystolitholapaxy, you'll usually need to stay in hospital for a few days to recover.

If you have had an open cystostomy, it may be several days before you're well enough to go home.

After surgery, you may be asked to attend a follow-up appointment where an X-ray or CT scan can be used to check that all fragments of the bladder stones have been removed from your bladder.

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Treating the underlying cause

Once the bladder stones have been removed, the underlying cause will need to be treated to avoid new bladder stones forming.

Prostate enlargement

Prostate enlargement can be treated using medication to help reduce the size of the prostate. This will relieve the pressure on the bladder, making it easier for you to pee.

If medication doesn't work, surgery may be needed to remove some or all of the prostate.

Read more about treating prostate enlargement.

Neurogenic bladder

A neurogenic bladder is an inability to control the bladder because of nerve damage.

If you develop bladder stones and have this condition, it's often a sign you need to change the way you're draining your bladder.

You may need further training in fitting your catheter, or you may need to change the type of catheter you're using and use medication to help control the bladder.

Read more about urinary catheterisation.

Cystocele

Some people with a cystocele (where the walls of the bladder weaken and drop down into the vagina) can be treated using a device called a pessary.

A pessary is designed to fit inside the vagina and hold the bladder in its correct position.

More severe cases of cystocele may require surgery to strengthen and support the walls of the bladder.

Bladder diverticula

If you have bladder diverticula (pouches that develop in the wall of the bladder), surgery may be needed to remove them.

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