Bladder calculus
Updates to Article Attributes
Bladder calculi occur either from migrated renal calculi or urinary stasis. Bladder calculi can be divided into primary and secondary stones:
- primary: stones form de novo in the bladder
-
secondary: stones are either from renal calculi which have migrated down into the bladder
, oror from concretions on foreign material (e.g. urinary catheters)
Epidemiology
Primary bladder calculi, in otherwise normal bladders, were previously common, but are now very uncommon in Western nations 2. When encountered, the most common cause is due to urinary stasis, including from:
Family history is found in up to one third-third of idiopathic cases 2.
Clinical presentation
Bladder calculi may present with pain, infection, haematuria or may be asymptomatic.
Radiographic features
Plain radiograph
Usually densely radiopaque, calculi may be single or multiple and are often large. Frequently lamination is observed internally, like the skin of an onion.
Ultrasound
Sonographically they are mobile, echogenic, and shadow distally. They may be associated with bladder wall thickening due to inflammation.
Treatment and prognosis
The earliest method of operative removal of bladder calculus was performed via the perineal route with the patient in a supine position and the legs elevated, hence the term lithotomy position.
-<strong>secondary:</strong> stones are either from <a href="/articles/urolithiasis">renal calculi</a> which have migrated down into the <a href="/articles/bladder">bladder</a>, or from concretions on foreign material (e.g. <a title="Foley urinary catheter" href="/articles/foley-catheter">urinary catheters</a>)</li>- +<strong>secondary:</strong> stones are either from <a href="/articles/urolithiasis">renal calculi</a> which have migrated down into the <a href="/articles/bladder">bladder</a> or from concretions on foreign material (e.g. <a href="/articles/foley-catheter">urinary catheters</a>)</li>
-</ul><p>Family history is found in up to one third of idiopathic cases <sup>2</sup>.</p><h4>Clinical presentation</h4><p>Bladder calculi may present with <a title="Acute abdominal pain" href="/articles/acute-abdominal-pain">pain</a>, infection, haematuria or may be asymptomatic.</p><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>Usually densely radiopaque, calculi may be single or multiple and are often large. Frequently <a title="Lamination (term)" href="/articles/lamellated-term">lamination</a> is observed internally, like the skin of an onion.</p><h5>Ultrasound</h5><p>Sonographically they are mobile, echogenic, and shadow distally. They may be associated with <a title="Bladder wall thickening (differential)" href="/articles/bladder-wall-thickening-differential">bladder wall thickening</a> due to inflammation.</p><h4>Treatment and prognosis</h4><p>The earliest method of operative removal of bladder calculus was performed via the perineal route with the patient in a supine position and the legs elevated, hence the term <a title="Lithotomy position" href="/articles/lithotomy-position">lithotomy position</a>.</p>- +</ul><p>Family history is found in up to one-third of idiopathic cases <sup>2</sup>.</p><h4>Clinical presentation</h4><p>Bladder calculi may present with <a href="/articles/acute-abdominal-pain">pain</a>, infection, haematuria or may be asymptomatic.</p><h4>Radiographic features</h4><h5>Plain radiograph</h5><p>Usually densely radiopaque, calculi may be single or multiple and are often large. Frequently <a href="/articles/lamellated-term">lamination</a> is observed internally, like the skin of an onion.</p><h5>Ultrasound</h5><p>Sonographically they are mobile, echogenic, and shadow distally. They may be associated with <a href="/articles/bladder-wall-thickening-differential">bladder wall thickening</a> due to inflammation.</p><h4>Treatment and prognosis</h4><p>The earliest method of operative removal of bladder calculus was performed via the perineal route with the patient in a supine position and the legs elevated, hence the term <a href="/articles/lithotomy-position">lithotomy position</a>.</p>
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