Bladder stones

Diagnosing bladder stones may involve:

• A physical exam. Your doctor will likely feel your lower abdomen to see if your bladder is enlarged (distended) or may perform a rectal exam to determine whether your prostate is enlarged. You'll also discuss any urinary signs or symptoms that you're having.
• A urine test. A sample of your urine may be collected and examined for microscopic amounts of blood, bacteria and crystallized minerals. A urine test also looks for a urinary tract infection, which can cause or be the result of bladder stones.
• CT scan. CT uses X-rays and computers to quickly scan and provide clear images of the inside of your body. CT can detect even very small stones. It's one of the most-sensitive tests for identifying all types of bladder stones.
• Ultrasound. This test bounces sound waves off organs and other structures in your body to create images that help detect bladder stones.
• X-ray. An X-ray of your kidneys, ureters and bladder helps your doctor determine whether you have bladder stones. Some types of stones can't be seen on conventional X-rays, however.

Drinking lots of water may help a small stone pass naturally. However, because bladder stones are often caused by difficulty emptying your bladder completely, extra water may not be enough to make the stone pass.

Most of the time, you'll need to have the stones removed. There are a few ways to do this.

Breaking stones apart

In one method, you're first given numbing medication or general anesthesia to make you unconscious. After that, a small tube with a camera at the end is inserted into your bladder to let your doctor see the stone. Then, a laser, ultrasound or other device breaks the stone into small pieces and flushes them from the bladder.

Surgical removal

Occasionally, bladder stones are large or too hard to break up. In these cases, your doctor will surgically remove the stones from your bladder.

If your bladder stones are the result of a bladder outlet obstruction or an enlarged prostate, these problems need to be treated at the same time as your bladder stones, typically with surgery.

There's no evidence that herbal remedies can break up bladder stones. These stones are extremely hard and usually require a laser, ultrasound or other procedure for removal. Always check with your doctor before taking any alternative medicine therapy to be sure it's safe and that it won't cause any problems with other medications you're taking.

If you have signs and symptoms of bladder stones, you're likely to see your primary care doctor first. You may then be referred to a doctor who specializes in treating urinary tract disorders (urologist).

What you can do

To get ready for your appointment, make a list of:

• Any symptoms you're experiencing, including any that may seem unrelated to your condition
• Key personal information, including any major stresses or recent life changes
• All medications you're taking, as well as any vitamins or supplements

In addition:

• Be aware of any pre-appointment restrictions. Ask if there's anything you need to do in advance, such as restrict your diet.
• Ask a family member or friend to come with you. Someone who accompanies you may remember information that you missed or forgot.

It's also a good idea to make a list of questions for your doctor. For bladder stones, some basic questions to ask include:

• Is it possible my bladder stones could pass without treatment?
• If not, do they need to be removed, and what's the best method?
• What are the risks of the treatment you're proposing?
• What will happen if the stones aren't removed?
• Is there any medication I can take to eliminate bladder stones?
• How can I keep them from coming back?
• I have other health conditions. How can I best manage these conditions together?
• Are there any dietary restrictions that I need to follow?
• Will the stones come back?
• Do you have any printed materials that I can have? What websites do you recommend?

Don't hesitate to ask additional questions that may come up during your appointment.

What to expect from your doctor

Your doctor is likely to ask you a number of questions, such as:

• When did you begin experiencing symptoms?
• Have your symptoms been continuous or occasional?
• How severe are your symptoms?
• Have you had a fever or chills?
• Does anything seem to improve your symptoms?
• Does anything make your symptoms worse?