Bladder stones are mineral deposits that form in the bladder. They were once common among poor children and adolescents with poor diets but are now rare due to improved nutrition. Bladder stones can be primary, forming in sterile urine, or secondary, forming due to infection, outflow obstruction, or foreign bodies. They are usually composed of calcium oxalate but can also contain uric acid, triple phosphate, or cysteine depending on the individual's condition. Clinically, bladder stones cause symptoms like urinary frequency, pain during urination, blood in the urine, and interrupted urinary flow. Diagnosis is made through urine analysis, ultrasound, or x-ray. Treatment involves removing the cause if present as well as breaking

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