How are bladder stones removed?

Bladder stones can often be removed through an endoscopic procedure called cystolitholapaxy, in which the stone is broken into smaller fragments and removed through the urinary passage. The exact approach depends on the stone's size, number, location, symptoms, and the patient's underlying urinary condition. Larger or complex stones may require a different surgical approach in selected cases.

The treatment used to remove a bladder stone depends on the individual patient's condition. Before deciding on a procedure, the urologist may assess the stone using imaging or cystoscopy and also look for an underlying cause of incomplete bladder emptying.

1. Endoscopic Bladder Stone Removal

Endoscopic treatment is commonly used for symptomatic bladder stones.

A cystoscope or similar instrument is passed through the urethra into the bladder. The stone is then fragmented using an appropriate technique, and the pieces are removed.

Because the instrument is introduced through the urinary passage, there is generally no external surgical incision for this approach.

2. Cystolitholapaxy

Cystolitholapaxy is an endoscopic procedure used to break bladder stones into smaller pieces so they can be removed.

Depending on the stone's characteristics, the urologist may use:

• Laser energy.
• Mechanical fragmentation.
• Other suitable stone-breaking instruments.

The fragments are then removed from the bladder.

3. Laser Bladder Stone Removal

A laser can be used to fragment a bladder stone into smaller pieces.

Laser fragmentation may be particularly useful when the stone needs to be broken carefully before the fragments are removed.

The choice of technique depends on the stone and the surgeon's assessment.

4. Open Surgery

Open bladder stone surgery is used less commonly.

It may be considered for selected patients with:

• Very large stones.
• Complex stones.
• Multiple or difficult-to-treat stones.
• Situations where another open procedure is being performed at the same time.

The urologist determines whether an endoscopic or open approach is appropriate.

Can bladder stones be removed without an incision?

Many bladder stones can be removed without an external incision.

Endoscopic stone removal uses the natural urinary passage to access the bladder.

Whether this approach is suitable depends on the stone's size, number, location, and the patient's anatomy and medical condition.

Does removing the bladder stone treat the underlying problem?

Not necessarily. This is an important part of bladder stone management.

If the stone developed because the bladder cannot empty completely, the underlying cause may also need treatment.

Possible causes include:

• Enlarged prostate.
• Urethral stricture.
• Bladder dysfunction.
• Neurological bladder problems.

Treating the underlying problem can help reduce the risk of recurrent stones.

How long does bladder stone removal take?

The duration depends on factors such as:

• Stone size.
• Number of stones.
• Stone composition.
• Treatment technique.
• Whether another urinary procedure is performed at the same time.

Your urologist can provide a more specific estimate after evaluating your condition.

What happens after bladder stone removal?

After the procedure, patients may experience temporary urinary discomfort or increased frequency.

Your doctor may recommend follow-up to:

• Confirm that the bladder has emptied properly.
• Monitor urinary symptoms.
• Evaluate the underlying cause.
• Reduce the risk of recurrence.

When Should I See a Urologist?

Seek urological evaluation if you have:

• A confirmed bladder stone.
• Difficulty passing urine.
• Blood in the urine.
• Pain or burning during urination.
• Frequent or urgent urination.
• Recurrent urinary infections.
• Weak or interrupted urine flow.
• Recurrent bladder stones.

Sudden inability to pass urine requires prompt medical attention.

SCI International Hospital

At SCI International Hospital, New Delhi, Dr. Gautam Banga, Senior Consultant Urologist and Andrologist, evaluates patients with bladder stones, urinary obstruction, enlarged prostate, urethral stricture, and recurrent urinary problems. After assessing the stone and the underlying urinary condition, an appropriate stone-removal approach can be planned, including endoscopic treatment when suitable.