urinary bladder stone

1. BLADDER
CALCULI
Dr. Nawin Kumar

2. bladder stone- Incidence
Until the twentieth century, bladder stone was a
prevalent disorder among poor children and
adolescents.
As a result of improved diet, especially an
increased protein:carbohydrate ratio, primary
vesical calculus is rare.

3. bladder stone- types
primary bladder stone secondary bladder stone
• develops in sterile
urine;
• it often originates in
the kidney

4. bladder stone- types
primary bladder stone secondary bladder stone
• occurs in the
presence of
infection, outflow
obstruction,
impaired bladder
emptying or a
foreign body

5. bladder stone- composition

6. • Mixed - most common
bladder stone- composition

7. • Calcium Oxalate stones
• primary stones
• Moderate size
• Solitary
• uneven surface
• Dark brown
bladder stone- composition

8. • Uric acid stones
• Round to oval
• Smooth
• Yellow to brown
• Occur in patients with gout
• ileostomies or with bladder outflow obstruction
bladder stone- composition

9. • TRIPLE PHOSPHATE CALCULUS -
• composed of ammonium, magnesium and calcium
phosphates (MAC)
• Infected urine with urea splitting organisms
• Grows rapidly
• Dirty white
• Chalky in consistency
bladder stone- composition

10. • Cysteine calculus
• Presence of cystinuria
• Radio-opaque
• High sulphur content
bladder stone- composition

11. bladder stone- position
• A bladder stone- free to move, gravitates to the
lowest part of the bladder.
• Less commonly hidden in a diverticulum,

12. bladder stone- Clinical features
• Men >women. 8:1

13. bladder stone- Clinical features
• Frequency : sensation of incomplete bladder
emptying.

14. bladder stone- Clinical features
• Pain (strangury)
• occurs at the end of micturition refered to tip of
penis
• Pain is worsened by movement

15. bladder stone- Clinical features
• Haematuria drops of bright-red blood at the end of
micturition

16. bladder stone- Clinical features
• 5.Interruption of the urinary stream stone blocking
the internal meatus.

17. bladder stone- Clinical features
• UTI

18. bladder stone- Examination
• Per abdomen : large calculus is palpable in the
female in suprapubic region

19. bladder stone- Investigation
• urine reveals
• 1. microscopic haematuria,
• 2. pus or crystals that are typical of the calculus

20. bladder stone- Investigation
• urine reveals
• 1. microscopic haematuria,
• 2. pus or crystals that are typical of the calculus

21. bladder stone- Investigation
• Ultrasound abdomen

22. bladder stone- Investigation
• X ray KUB

23. bladder stone- management
• Treat the cause
• Bladder outflow obstruction
• Incomplete bladder emptying in patients with
neurogenic bladder dysfunction

24. bladder stone- management
• Treat the stone
• Lithotripsy
• Cystoscopic litholapaxy
• Per cutaneous suprapubic litholapaxy
• Suprapubic cystolithotomy

25. bladder stone- management
• Treat the stone
• Lithotripsy with electrohydraulic lithotrite

26. bladder stone- management
• Treat the stone
• Lithotripsy with blind lithotrite

27. bladder stone- management
• Treat the stone
• Lithotripsy with holmium laser

28. bladder stone- management
• Treat the stone
• Lithotripsy with ultrasound probe

29. bladder stone- management
• Treat the stone
• Lithotripsy with pneumatic probe

30. bladder stone- management
• Treat the stone
• Lithotripsy with optical lithotrite

31. bladder stone- management
• Treat the stone
• Cystoscopic litholapaxy

32. bladder stone- management
• Treat the stone
• Per cutaneous suprapubic litholapaxy

33. bladder stone- management
• Treat the stone
• Suprapubic cystolithotomy

34. bladder stone- management
• Treat the stone
• Suprapubic cystolithotomy

35. bladder stone- management
• Treat the stone
• Suprapubic cystolithotomy

36. bladder stone- management
• Treat the stone
• Suprapubic cystolithotomy

37. bladder stone- management
• Treat the stone
• Suprapubic cystolithotomy

38. bladder stone- management