Introduction
Water makes up more than 90 % of urine. The rest comprises minerals like salt and waste products like protein. Depending on the type of waste and minerals present, concentrated urine can range in color from dark amber to brown. Dehydration or an inability to completely empty the bladder are common causes of concentrated urine. This could be because of an enlarged prostate, bladder issues, or urinary tract infections (UTIs). Bladder calculi are crystallized minerals that form in the bladder after urination when concentrated urine hardens. They can cause infections and other complications if not treated.
What Is Bladder Calculi?
Bladder calculi form when minerals in urine crystallize and clump together in the bladder. They form due to mineral buildup that occurs when the bladder does not empty completely after urination. Eventually, the urine becomes concentrated, and the minerals in the liquid crystallize. Uric acid, a chemical released by the body when it breaks down substances, is the most common component of bladder calculi. Bladder calculi can remain in the bladder for an extended period and do not always cause symptoms. However, they are frequently discovered when a person undergoes an X-ray for another medical reason.
Larger bladder calculi may require removal by a medical professional. It can be a single or a group of stones formation. The stones' shapes vary; some are nearly spherical, while others are irregular. A "jackstone" is a type of bladder stone shaped like a jack, similar to the children's game jacks.
What Causes Bladder Calculi?
Bladder calculi form when urine sits in the bladder for an extended period. The bladder is a component of the urinary system. Urine becomes concentrated when it sits in the bladder for an extended period. Urine minerals harden and form crystals that clump together. This occurs when one is unable to empty their bladder completely. The following conditions and factors raise the likelihood of bladder calculi, such as:
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Augmentation Cystoplasty: During a bladder augmentation procedure, the doctor uses bowel tissue to expand the bladder and improve its function. Urine can sometimes pool in the bladder as a result of the procedure.
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Bladder Diverticula: Pockets or pouches in the bladder make it difficult to empty the bladder completely. This condition can develop at birth or later in life due to a disease or an enlarged prostate.
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Dehydration: Usually, water dilutes the minerals in the urine and flushes the bladder. As the minerals build up in concentrated urine, dehydration (not drinking enough fluids) can result in bladder calculi.
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Prostate Enlargement: As men age, the prostate can enlarge, putting pressure on the urethra. The added pressure can make it difficult to empty the bladder completely.
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Fallen Bladder: After childbirth, some women develop a condition known as a cystocele. Weakening bladder walls fall into the vagina and obstruct urine flow.
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Kidney Stones: A kidney stone can sometimes pass from the kidney into the bladder. If the stone can pass into the bladder, it is usually easily urinated out of the bladder. In patients with difficulty urinating, the stone can become stuck and grow larger inside the bladder, causing pain and difficulty urinating.
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Neurogenic Bladder: Nerve damage caused by a spinal cord injury, stroke, other diseases, or congenital abnormality can impair bladder function. People with neurogenic bladder frequently require a catheter to drain their bladder. Catheters cannot always drain all of the urine.
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Medical Equipment: Patients with bladder devices, such as catheters, may develop bladder calculi due to crystals that form on the device. This is usually the case if the device has been in the body for longer than recommended.
What Are the Signs and Symptoms of Bladder Calculi?
Some bladder calculi pass through the body with the urine and cause no symptoms. However, large bladder calculi can irritate the bladder, causing severe pain, bleeding, and urination problems. Among the signs and symptoms are:
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Urine Color Changes: Presence of cloudy or dark urine or blood in the urine.
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Frequent Urge To Urinate: One may feel as if they need to urinate frequently, even if they just peed.
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Pain: It is common for bladder calculi to cause pain or burning when urinating. One may also experience intermittent pain in the lower abdomen (belly). Men occasionally experience pain in the penis or testicles.
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Stopping and Starting: Even if the urge to urinate is very strong, one may have difficulty starting the urine flow. The urine stream occasionally stops and restarts (urinary intermittency).
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Urinary Tract Infections: Bladder calculi can cause urinary tract infections (UTIs). Symptoms of a UTI include frequent, painful urination and cloudy, foul-smelling urine.
How Is Bladder Calculi Diagnosed?
Various tests can be used to diagnose bladder calculi:
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Physical Examination: A doctor may place their hands on a patient's lower abdomen to determine whether or not their bladder is enlarged. If the patient has a prostate, the doctor may examine it to see if it is enlarged.
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Urinalysis: A urine sample may be analyzed for blood, bacteria, and crystallized minerals.
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Spiral CT Scan: CT scans combine multiple X-ray images to create a detailed image of internal organs.
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Ultrasound: An image is created by bouncing high-frequency sound waves off internal organs.
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Cystoscopy: During this procedure, the doctor looks inside the bladder with a small scope to check for calculi. The scope is flexible and thin, with a camera on end.
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X-Ray: An X-ray may be advised by a healthcare professional; however, not all bladder calculi are visible on an X-ray.
How Is Bladder Calculi Treated?
A urologist is usually required to remove bladder calculi from the bladder. They can be dissolved very rarely, but it depends on the type of calculi and can take a long time. Bladder calculi treatment includes the following steps:
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Cystolitholapaxy: During the procedure of cystolitholapaxy, doctors use a scope to visualize the bladder calculi and then use lasers or ultrasound to break the bladder calculi into tiny pieces (high-frequency sound waves). The fragments are then extracted from the bladder.
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Surgery: If the calculi are particularly large, open surgery may be required to remove them. The doctor will make an incision in the abdomen and remove the calculi.
Conclusion
Some small bladder calculi may pass through the body without being treated. However, for the vast majority of those who do not pass on their own, doctors can remove them using minimally invasive procedures or surgery. Bladder calculi do not cause long-term health problems when properly treated. It is critical to seek treatment as soon as possible and to address any underlying health issues that may be causing bladder calculi. Early treatment can alleviate symptoms, help avoid long-term damage, and prevent bladder calculi from recurring.
