Treatment of bladder stone

Cystolithiasis - or bladder stones, along with stones in the kidneys, ureters and urethra, are one of the manifestations of urolithiasis. Their formation can be due to both a violation of the physicochemical properties of urine (the solubility of the organic and inorganic compounds contained in it), and physiological factors (congenital or acquired metabolic disorders: metabolic, inflammatory, drug, etc.). Depending on the site and mechanism of formation, bladder stones can vary in size, number, consistency, surface type, shape, color, and chemical composition. 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, phosphates or calcium oxalates. Bladder stones are observed predominantly in the male population in childhood (in the first 6 years of life) and old age (over 50 years). The mechanism of stone formation is associated with the inability to completely empty the bladder, stagnation and the concentration of residual urine, leading to the loss of salt crystals. Stone formation is facilitated by a neurogenic bladder, its omission in women with cystothelius, existing defects in the internal muscular membrane, including diverticula. Sometimes, in the presence of stones in the kidneys and upper urinary tract, small stones migrate along the ureter 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 stone formation.

TREATMENT

In the surgical removal of stones from the bladder, endoscopic lithoextraction, stone crushing (contact transurethral cystolithotripsy, percutaneous suprapubic litholapaxy, remote cystolithotripsy) and stone section (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, electro-hydraulic or laser lithotripter), and their fragments are removed through a cystoscope by washing and suction. Biopsy and histological examination of the tissues of the bladder is performed after surgery in case of noticeable changes in its wall with a long-term and untreated urolithiasis.

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