Bladder stones are one of the common diseases of the urinary tract, with common clinical manifestations such as painful urination, difficulty in urination and hematuria. Due to the irritation of stones on the low mucosa of the bladder, they often cause urinary frequency and urgency, and the pain is aggravated at the end of urination, which is mainly located in the pubic go or perineum. The presence of stones can easily lead to urinary tract infection, making urinary frequency and urgency more pronounced, and inflammatory stimulation can in turn cause hematuria and pus urine. During urination, stones that block the posterior urethra or bladder outlet often cause interruption of urination, resulting in sudden and severe pain that can radiate to the head of the penis or even the perineum. After the interruption, the patient moves the body or changes position, and if the blocked stone moves away, the symptoms of difficult and painful urination are quickly relieved.
Children with bladder stones often have unbearable pain, sweat profusely, cry, and pull the penis with their hands. If the stone is significantly embedded, it will cause acute urinary incontinence symptoms and the lower abdomen will be significantly penglonged.
Most kidney stones in the elderly are caused by the prostate in hyperplasia, which can be accompanied by symptoms of prostate enlargement. A few chronic patients with large stones and significant lower urinary tract obstruction often have atypical clinical manifestations.
The persistence of bladder stones irritates the bladder mucosa, causing inflammation and bleeding, which initially manifests as terminal hematuria. Persistent hematuria may occur if bleeding is high.
It is also recommended that bladder stones be treated promptly because of the possibility of bladder tumors due to long-term bladder stone irritation.
Usually bladder stones less than 6 mm in diameter, if the surface is smooth and flat, and there is no lower urinary tract obstruction, the patient can expel them on his own, and usually no special treatment is needed. The vast majority of bladder stones require extracorporeal shock wave lithotripsy, endoscopic surgery or open surgery to remove the stone. In children, extracorporeal shock wave lithotripsy is usually performed, and in adults, extracorporeal shock wave lithotripsy is also an option for simple bladder stones less than 3 cm in diameter.
Due to the popularity of cystotomy, most of the timely bladder stones can be removed and lithotripsy can be performed by cystoscopy. After surgery, the bladder can be flushed under direct vision, which is more efficient, less invasive, safe and effective for stone extraction.
Suprapubic cystotomy is the traditional way of stone extraction, which also has its advantages. For patients with larger and more bladder stones, stones formed by foreign bodies around the bladder, bladder stones that cannot be broken by endoscopy, patients with combined severe prostatic hyperplasia, urethral stricture, bladder tumor or bladder neck contracture, and patients with severely impaired renal function with ureteral reflux, open surgery can be used to retrieve stones.