Why bladder stones form
Urine that stagnates in the bladder crystallises. The commonest reason in men over fifty is prostate enlargement obstructing outflow; other causes include urethral stricture, a neurogenic bladder, or a long-standing catheter. Removing the stone without treating the cause simply buys a few months.
- Difficulty starting or a weak, interrupted stream
- Pain at the tip of the penis at the end of urination
- Blood in the urine, particularly after activity
- Repeated urine infections
- Sudden stoppage of flow that changes with position
The procedure
Under anaesthesia a cystoscope is passed through the urethra, the stone is broken with a laser or lithoclast, and all the fragments are evacuated. No abdominal cut is required for most stones. Where the prostate is the cause, a TURP or HoLEP can be done in the same anaesthesia so the problem does not recur.
Recovery
Usually one night in hospital, with a catheter overnight if the prostate was treated at the same time. Burning for two to three days is expected. Normal routine resumes within a week, and a check ultrasound confirms both an empty bladder and no residual stone.
Bladder Stone Removal — common questions
Can bladder stones be dissolved with medicine?
No. Once a bladder stone has formed it needs to be removed. Medication has a role only in preventing recurrence once the outflow problem is corrected.
Is open surgery ever needed for a bladder stone?
Rarely — only for very large or extremely hard stones, or when the bladder needs to be opened for another reason during the same operation.
Will the stone come back after removal?
Not if the underlying cause is fixed. If prostate obstruction or a stricture is left untreated, recurrence within a year or two is common.
Is bladder stone surgery safe in an elderly patient?
Yes, and usually safer than leaving the stone. The procedure is short, endoscopic, and can be done under spinal anaesthesia after a cardiac and anaesthetic assessment.
Reviewed by Dr. Kinjal Banerjee, MBBS, MS (General Surgery), DNB (Urology) — Urologist, Renal Transplant & Robotic Surgeon, Faridabad. This page explains bladder stone removal in general terms; your own treatment plan depends on your reports and examination.