Bladder stones: symptoms, causes, treatment and prevention

The NHS says the main symptoms are pain in the lower tummy (abdomen), pain or burning when you pee, peeing more often than usual including at night, blood in your pee, difficulty peeing or not being able to pee at all, and having frequent urinary tract infections (UTIs).

These symptoms can also be caused by other conditions. The NHS stresses it is important to get them checked because they can sometimes be caused by more serious conditions, such as prostate cancer or bladder cancer, and that if cancer is the cause, finding it early may make it easier to treat.

• Pain in the lower tummy that is not getting better.

• Pain or burning when you pee.

• Needing to pee more often than usual, including at night.

• Blood in your pee, which may look bright pink, red or dark brown.

• Difficulty peeing, or not being able to pee at all.

• Frequent urinary tract infections.

The NHS says small bladder stones sometimes come out when you pee, but larger bladder stones will usually need to be removed. You will also need treatment for what is causing your bladder stones, to stop them coming back.

The most common type of surgery is a cystolitholapaxy (sometimes called an endoscopic litholapaxy). The NHS describes the procedure: you have a local anaesthetic, where you are awake, or a general anaesthetic, where you are asleep, so you should not feel any pain. A thin tube with a camera at the end (a cystoscope) is passed into the urethra and up into the bladder to find the stones. Small stones are flushed out using liquid. Larger stones are broken up into smaller pieces with a crushing device, sound waves or a laser and then flushed out.

The NHS says a cystolitholapaxy usually takes between 15 minutes and 1 hour. After the procedure you may have a catheter put in to help drain urine from your bladder until you can pee normally again, usually a few days later, and you may need to stay in hospital for 1 to 3 nights. If you cannot have a cystolitholapaxy, you may be offered a different type of surgery, and a doctor will talk to you about the risks and possible side effects.

The NHS says you can get bladder stones if you have a condition that stops you emptying all the pee from your bladder. Over time, the minerals in your pee clump together and form stones.

• An enlarged prostate, where the prostate blocks the tube you pee through (urethra).

• Bladder prolapse (cystocele), where the muscles around the bladder have weakened and the bladder is pushing down into the vagina.

• Damaged nerves in the bladder (neurogenic bladder), for example from a spinal injury or a condition such as spina bifida or motor neurone disease.

• Small pockets in the lining of the bladder (bladder diverticula).

• Constipation.

The NHS says that if a GP thinks you might have bladder stones, you may need tests on a sample of your pee, a blood test, scans such as an ultrasound or CT scan, and a cystoscopy, in which a long, thin tube with a small camera is passed through the urethra into the bladder.

For an enlarged prostate, which is a common underlying cause, the NHS says the GP may ask you to keep a record for at least 3 days of how much you drink and how often and how much you pee, and tests may include a pee sample and a PSA blood test, with referral to a specialist for tests such as a urine flow test, bladder ultrasound or cystoscopy.

The NHS says that if you have had bladder stones there is a risk they may come back, and lists things you can do to help.

• Drink plenty of fluids.

• Pee when you need to go, and do not hold on or wait.

• If you feel like you still need to pee after peeing, try again 10 to 20 seconds afterwards.

• Eat a healthy balanced diet, including plenty of fruit and vegetables, to avoid constipation.

• Get any underlying cause treated, such as an enlarged prostate.

The NHS describes bladder stones in adults as forming because the bladder does not empty fully, rather than because of a particular food. The dietary advice it gives is to drink plenty of fluids and to eat a healthy balanced diet with plenty of fruit and vegetables to avoid constipation.

The NHS does not recommend a specific stone diet. If you have had stones, your urology team can advise on whether any further tests or changes are suitable for you.

An enlarged prostate is one of the commonest causes listed by the NHS. It says an enlarged prostate is common, most common in men over 50, and can put pressure on the urethra and cause problems with peeing. It may not always need treatment, but if symptoms are moderate or severe you may be offered medicines or surgery such as transurethral resection of the prostate (TURP).

Treating the enlarged prostate where it is the cause helps to stop stones coming back, which is why the NHS says you will need treatment for what is causing your bladder stones.

The NHS says to see a GP if you have pain in your lower tummy that is not getting better, pain when you pee, you need to pee more often than usual, or you are having difficulty peeing.

Ask for an urgent GP appointment or get help from NHS 111 if you have a very high or low temperature, feel hot or cold or are shivery, you have blood in your pee, or you have severe pain when peeing.

Bladder stones are diagnosed and treated through urology services after a GP assessment, and the usual operation is the same in NHS and private hospitals. The NHS says a doctor will talk to you about the risks and possible side effects of surgery.

Some people choose to pay for a faster urology appointment, scan or cystoscopy. If you do, ask for the results and operation notes to be shared with your GP, and make sure the underlying cause, such as prostate enlargement or incomplete bladder emptying, is addressed as well as the stone itself.