Cystolithiasis or bladder stones, along with stones in the kidneys, ureters and urethra, are one of the manifestations of urolithiasis. Their formation can be caused both by a violation of the physicochemical properties of urine (the solubility of organic and inorganic compounds contained in it), and by physiological factors (congenital or acquired metabolic disorders: metabolic, inflammatory, medicinal, etc.). Bladder stones can vary in size, quantity, consistency, surface type, shape, color, and chemical composition, depending on the location and mechanism of formation. Bladder stones can be single (solitary) and multiple, small (microliths) and large (macroliths), smooth, rough and faceted, soft and very hard; contain uric acid, uric acid salts, calcium phosphates or oxalates. Bladder stones are observed mainly in the male population in childhood (in the first 6 years of life) and old age (over 50). The mechanism of stone formation is associated with the impossibility of complete emptying of the bladder, stagnation and concentration of residual urine, leading to the loss of salt crystals. The formation of stones is facilitated by the neurogenic bladder, its prolapse in women with cystothelium, the existing defects of the inner muscular membrane, including diverticula. Sometimes, in the presence of calculi in the kidneys and upper urinary tract, migration of small stones along the ureter is observed with their further appearance and persistence in the bladder. The presence of foreign bodies (stents, ligatures, catheters, and other foreign objects) in the bladder can cause salt deposits and stones to form on them.
In the operative removal of stones from the urinary bladder, endoscopic lithoextraction, stone crushing (contact transurethral cystolithotripsy, percutaneous suprapubic litholapaxia, remote cystolithotripsy) and stone cutting (open suprapubic cystolithotomy) are used. Transurethral lithotripsy is performed for adult patients during cystoscopy, while the stones found under visual control are crushed with a special device (ultrasonic, pneumatic, electrohydraulic or laser lithotripter), and their fragments are removed through a cystoscope by washing and suction. Biopsy and histological examination of the bladder tissue is performed after the operation in case of noticeable changes on the side of its wall with long-standing and untreated urolithiasis.
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