What are the risks of bladder stone surgery?

Bladder stone removal is generally an established and commonly performed treatment, but like any medical procedure, it can have potential risks. Depending on the procedure, possible complications may include bleeding, urinary tract infection, temporary difficulty passing urine, discomfort during urination, or injury to the urinary tract. The individual risk depends on the stone, procedure, and patient's overall health.

Most symptomatic bladder stones are treated using an endoscopic procedure such as cystolitholapaxy, where the stone is fragmented and removed through the urinary passage.

Although this approach avoids an external surgical incision in many cases, patients should understand the potential risks before treatment.

1. Blood in the Urine

Some blood in the urine can occur temporarily after bladder stone removal because instruments are introduced through the urinary tract and the bladder may be irritated during treatment.

Your doctor will explain what amount and duration of bleeding is expected after your procedure.

2. Urinary Tract Infection

A urinary tract infection can occur after an endoscopic urinary procedure.

Symptoms may include:

• Fever.
• Chills.
• Burning during urination.
• Increased urinary frequency.
• Lower abdominal discomfort.

If you develop fever or worsening symptoms after the procedure, contact your medical team promptly.

3. Burning or Urinary Discomfort

Temporary burning or discomfort during urination is relatively common after instrumentation of the urinary tract.

These symptoms generally improve as the urinary tract recovers.

4. Difficulty Passing Urine

Some patients may temporarily have difficulty passing urine after bladder stone surgery.

This can be influenced by factors such as:

• Pre-existing urinary obstruction.
• Enlarged prostate.
• Urethral narrowing.
• Swelling or irritation following the procedure.

A temporary urinary catheter may sometimes be required.

5. Injury to the Urinary Tract

Endoscopic procedures involve instruments passing through the urethra into the bladder.

Although uncommon, injury to the urethra or bladder can occur.

The specific risk depends on the procedure and the patient's anatomy and medical condition.

6. Incomplete Stone Clearance

In some cases, particularly with large, multiple, or complex stones, it may not be possible to remove every fragment during one procedure.

Additional treatment may occasionally be required.

7. Recurrence of Bladder Stones

Bladder stones can come back after treatment.

This is particularly important when the underlying cause of stone formation is not addressed.

For example, continued incomplete bladder emptying caused by:

• Enlarged prostate.
• Urethral stricture.
• Bladder dysfunction.

may increase the risk of another stone forming.

8. Need for Additional Treatment

Some patients may require further treatment if:

• A stone is particularly large.
• Multiple stones are present.
• The stone cannot be completely cleared.
• An underlying urinary obstruction requires treatment.
• Complications develop.

Your urologist can explain the likelihood of additional treatment based on your individual findings.

Are the Risks the Same for Every Patient?

No. Risk depends on several factors, including:

• Stone size.
• Number of stones.
• Stone location.
• Type of procedure.
• Presence of urinary infection.
• Enlarged prostate.
• Urethral stricture.
• Other medical conditions.
• Previous urinary procedures.

A personalized assessment is therefore important before treatment.

How Can the Risk of Complications Be Reduced?

Your medical team may recommend:

• Treating an active urinary infection before elective stone removal.
• Reviewing current medications.
• Evaluating urinary obstruction.
• Assessing bladder emptying.
• Following postoperative instructions carefully.
• Attending recommended follow-up appointments.

Most importantly, the underlying cause of bladder stone formation should be evaluated to reduce the chance of recurrence.

When Should I Seek Medical Attention After Surgery?

Contact your healthcare team promptly if you develop:

• Fever or chills.
• Severe or worsening pain.
• Heavy or persistent bleeding.
• Inability to pass urine.
• Significant worsening of urinary symptoms.
• Other concerning symptoms after the procedure.

Sudden inability to urinate 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. Before treatment, the stone and underlying urinary condition can be assessed so that an appropriate procedure and postoperative care plan can be selected.