Bladder stones

The majority of bladder stones in Western practice are secondary to underlying pathology—bladder outlet obstruction due to benign prostatic enlargement in men and urethral obstruction from pelvic prolapse or cystocele in women, chronic infection in the neuropathic or augmented bladder, or in the neobladder. While the pathology of endemic bladder stones remains as it always was, the advent of augmentation cystoplasty and rising use of the neobladder after cystectomy has, through a different pathological mechanism, led to a rise in frequency of bladder stones. The mode of presentation of bladder stones and diagnostic technique are reviewed in this chapter. Treatment options are determined, to a significant degree, by the clinical context in which the stone arise, the major determinant of the approach to such stones being the calibre of the conduit (urethra or Mitrofanoff) through which access to the bladder is achieved.