Bladder Stone Removal

Bladder removal surgery, known as cystectomy, involves the complete or partial removal of the bladder. This procedure is primarily performed to treat bladder cancer, severe bladder dysfunction, or other serious medical conditions affecting the bladder.

Symptoms of Bladder Stones

Causes of Bladder Stones

Bladder stones form when urine in the bladder becomes concentrated, allowing minerals to crystallize and harden. There are several causes for this:

1. Incomplete Bladder Emptying: If the bladder doesn’t fully empty during urination, leftover urine becomes concentrated, leading to stone formation. This can happen due to conditions like an enlarged prostate or nerve damage that affects bladder control.

2. Urinary Tract Infections (UTIs): Repeated infections can cause minerals to collect and form stones in the bladder.

3. Bladder Diverticula: Pockets or pouches in the bladder wall can trap urine, making it harder to fully empty, which increases the risk of stone formation.

4. Foreign Objects: Devices like catheters can sometimes lead to stone formation if they irritate the bladder or cause infections.

5. Diet and Dehydration: Not drinking enough water leads to more concentrated urine, which increases the chance of bladder stones.

Bladder Stone Diagnosis

It is a combination of reviewing one's past medical history, physical examination, and subjecting the patient to different diagnostic tests to make a diagnosis of bladder stones. 

1. Medical History & Physical Examination: Symptoms will be asked of the patients and recorded and physical examination, including lower abdominal inspection and rectal examination for men.

2. Urine Tests: Urine tests called urinalysis tests indicate blood, bacteria (evidence of infection), and crystallization of minerals.

3. Imaging Tests: Various imaging tests are used:

• X-ray: Some of the bladder stones are detected by this.
• Ultrasound: This technique provides images of the bladder for stone identification.
• CT Scan: Gives detailed images for stone detection, even small ones. 
• CT urogram: It is a specialized urinary tract scan.

4. Cystoscopy: This involves the use of - a slender tube with a camera (cystoscope) inserted into the urethra and bladder so as to be able to look directly for stones.

Types of Bladder Stones Removal Surgeries

Bladder stone removal can be done through two main types of procedures, depending on the size and number of stones: cystolitholapaxy and open surgery.

1. Cystolitholapaxy (Minimally Invasive)

This is the most common method to remove bladder stones. Here’s how it works:

• A thin tube called a cystoscope with a camera is inserted through the urethra into the bladder.
• The doctor views the stones and uses laser, ultrasound, or mechanical devices to break them into small pieces.
• The small stone fragments are then flushed out or removed with the scope.
• This procedure is usually done under general or spinal anesthesia, meaning you won’t feel any pain during the surgery.

Recovery is faster with cystolitholapaxy, and it is less invasive.

2. Open Surgery

If the stones are too large or there are other complications, open surgery might be necessary:

• The doctor makes a small incision in the lower abdomen to directly access the bladder.
• The stones are then removed manually.

Open surgery is more invasive and has a longer recovery period but is needed in some cases.

After either procedure, addressing the underlying cause of bladder stones is essential to prevent them from recurring.

Remedies: The primary form of treatment for the condition is surgical bladder stone removal. Treatment options include surgeries that are minimally invasive, open surgery for larger stones, and cystolitholapaxy, which entails using ultrasound or laser treatment to break down the stones before removing them with a cystoscope. Moreover, changing your diet, consuming more water, and attending to underlying health issues are a few examples of preventative measures that may help decrease the frequency of recurring bladder stones.

The treatment procedure of bladder stone removal follows certain steps:

• Preoperative Evaluation: To determine the size, number, and position of bladder stones, the patient has preoperative assessments that include a review of their medical history, a physical examination, and imaging tests (such as CT or ultrasound).
• Anesthesia Administration: During the process, anesthesia is given to the patient in order to assure their comfort and safety. This could involve either spinal anesthesia or general anesthesia, based on the surgeon's preference and the patient's health.
• Cystoscopy: The bladder is reached through the urethra to implant a cystoscope, a thin tube equipped with a camera and light. With the cystoscope, the surgeon views the bladder and finds the stones.
• Stone Fragmentation: To break up stones, techniques including laser or ultrasonic lithography are employed. By using these techniques, stones become smaller and easier to remove.
• Stone Removal: The fractured stones are surgically removed from the bladder using a tube called a cystoscope and specialized equipment. Larger pieces can be removed with graspers, but smaller pieces can be washed away with irrigation.
• Bladder irrigation: The bladder can be irrigated with a saltwater solution to ensure that all of the stone particles are emptied out and to prevent aggravating the urinary tract.
• Postoperative Care: After the procedure, the patient is monitored in the recovery room until fully awake and stable. Postoperative instructions are provided, including wound care, pain management, and guidelines for resuming normal activities. Follow-up appointments are scheduled to monitor recovery and assess for any complications.