18 Devonshire Street
London
W1G 7AQ
info@londonurologyspecialists.co.uk
Stone Clinic
Bladder Stones
Hard mineral deposits that form in or migrate to the bladder, often linked to bladder outlet obstruction or incomplete emptying.
Clinically Reviewed By
Mr Alberto Coscione
Consultant Urological Surgeon · Reviewed July 2026 · Review due July 2027
What Are Bladder Stones?
Bladder stones (vesical calculi) are hard deposits of crystallised minerals that form within the bladder. They develop when urine in the bladder becomes concentrated and minerals precipitate into crystals. In some cases, small stones that originate in the kidney may pass down the ureter and lodge in the bladder, growing larger over time.
Bladder stones are significantly more common in men, particularly those over the age of 50. The most frequent underlying cause is bladder outlet obstruction, usually due to benign prostatic hyperplasia (BPH). When the prostate is enlarged, the bladder cannot empty completely, and the retained urine provides an environment in which stones can form and grow.
Bladder stones can grow to a considerable size within the bladder before causing noticeable symptoms. Their mechanism of formation is closely related to the underlying condition causing incomplete bladder emptying, rather than the metabolic and dietary factors more commonly associated with kidney stones.
Bladder stones vs kidney stones
Although both are urinary tract stones, bladder stones and kidney stones differ in their underlying causes and management. Kidney stones are most commonly caused by metabolic factors such as dehydration and dietary excess. Bladder stones, by contrast, usually result from incomplete bladder emptying due to obstruction, neurological conditions, or catheter use. Successful treatment of bladder stones requires addressing the root cause to prevent recurrence.
What Causes Bladder Stones?
Bladder stones almost always form as a consequence of another underlying condition that prevents the bladder from emptying fully. When residual urine remains in the bladder, minerals begin to crystallise and gradually accumulate into stones. The most common causes include:
Bladder Outlet Obstruction
The most common cause in men. An enlarged prostate (BPH) or urethral stricture (narrowing) can prevent complete bladder emptying. Stagnant urine leads to mineral crystallisation and stone formation.
Neurogenic Bladder
Conditions affecting the nerves that control bladder function, such as spinal cord injury, multiple sclerosis, or stroke, can impair the bladder's ability to contract and empty fully.
Urinary Catheter
Long-term indwelling catheters are a well-recognised risk factor. Minerals can encrust the catheter surface and form stones, particularly if infection is also present.
Foreign Materials
Any foreign material in the bladder, including migrated surgical mesh, sutures, or retained catheter fragments, can act as a nidus around which minerals crystallise to form a stone.
Bladder Augmentation
Patients who have undergone bladder augmentation surgery (using bowel segments to enlarge the bladder) are at increased risk due to mucus production and altered bladder physiology.
Dehydration & Recurrent UTIs
Chronic dehydration concentrates urine and promotes crystallisation. Recurrent urinary tract infections, particularly with urease-producing bacteria, can alter urine chemistry and accelerate stone growth.
Symptoms of Bladder Stones
Small bladder stones may not cause any symptoms at all and are sometimes discovered incidentally during investigation for other conditions. However, as stones grow larger or move within the bladder, they can produce a range of bothersome and sometimes distressing symptoms:
Lower abdominal pain
Pain or discomfort in the lower abdomen or suprapubic region, which may be dull and persistent or sharp during urination.
Dysuria (painful urination) — a burning or stinging sensation during urination, caused by the stone irritating the bladder lining.
Urinary frequency and urgency — the stone irritates the bladder wall, triggering the need to urinate more often and more urgently than normal.
Haematuria (blood in the urine) — the stone can abrade the bladder lining, causing visible or microscopic blood in the urine.
Interrupted urinary stream
A highly characteristic symptom of bladder stones. The stone intermittently rolls over the bladder neck or internal urethral opening, abruptly stopping the flow of urine. Changing position may restart the stream.
Recurrent urinary tract infections — bladder stones harbour bacteria and can cause repeated infections that do not fully resolve with antibiotics alone.
Urinary retention — in rare cases, a large stone may completely block the bladder outlet, leading to an inability to pass urine. This is a urological emergency requiring immediate attention.
How Are Bladder Stones Diagnosed?
A combination of imaging studies and direct visualisation is used to confirm the presence of bladder stones, assess their size and number, and identify the underlying cause. The investigations typically include:
Ultrasound
A non-invasive first-line investigation that can detect stones in the bladder and assess the post-void residual urine volume. It is also useful for evaluating prostate size in men with suspected BPH.
X-ray (KUB)
A plain abdominal X-ray can identify radio-opaque stones in the bladder. However, not all stone types are visible on X-ray (uric acid stones, for example, are radiolucent), so a negative X-ray does not exclude bladder stones.
CT Scan
A non-contrast CT scan of the urinary tract (CT KUB) is the gold-standard imaging modality for urinary stones. It detects all stone types regardless of composition, provides precise measurements, and can reveal additional pathology such as upper tract stones or other bladder abnormalities.
Cystoscopy (Definitive)
A flexible or rigid cystoscopy (a procedure that uses a small telescope to visualise the inside of the bladder) allows the urologist to directly view stones within the bladder, assess their size, number and composition, and evaluate the bladder lining and prostate. In many cases, cystoscopy is both diagnostic and therapeutic, as stones can be fragmented and removed during the same procedure.
Blood Tests
Blood tests including renal function, calcium, uric acid, and full blood count help identify metabolic factors that may be contributing to stone formation, and assess for any associated infection or kidney impairment.
Treatment Options
The treatment of bladder stones involves two key goals: removing the stone itself, and addressing the underlying cause to prevent recurrence. The approach depends on the stone size, number, composition, and the patient's overall health.
Cystolitholapaxy
Most Common ApproachCystolitholapaxy is the standard treatment for the majority of bladder stones. It is a minimally invasive endoscopic procedure performed under general or spinal anaesthesia. A rigid cystoscope is passed through the urethra into the bladder, and the stone is fragmented using laser, pneumatic, or ultrasonic energy. The fragments are then irrigated out or extracted with grasping forceps.
This approach avoids any external incisions, typically requires only a short hospital stay (often day-case), and has a rapid recovery. It is suitable for most stone sizes, though very large or extremely hard stones may require an alternative approach.
Percutaneous Suprapubic Cystolithotomy
For Very Large StonesFor very large bladder stones that cannot be efficiently fragmented endoscopically, a small incision is made in the lower abdomen just above the pubic bone. A tract is created into the bladder, through which the stone is fragmented and removed using direct-vision instruments. This approach provides a larger working channel than transurethral surgery and is well suited to stones measuring several centimetres in diameter.
Open Cystolithotomy
Rare — Complex Cases OnlyOpen surgery to remove bladder stones is now rarely required, but may be considered when stones are exceptionally large, multiple, or when concurrent open bladder or prostate surgery is planned. An incision is made in the lower abdomen, the bladder is opened, and the stones are removed directly.
Treating the underlying cause is essential
Simply removing the stone without addressing the reason it formed will almost certainly result in recurrence. If bladder outlet obstruction due to BPH is identified, prostate surgery (such as TURP, HoLEP, or Rezum) may be performed at the same time as or shortly after stone removal to ensure the bladder can empty properly. Learn more about enlarged prostate treatment →
Preventing Bladder Stones
Prevention centres on eliminating or managing the factors that caused the stone to form in the first place. Key measures include:
Treat the Underlying Cause
If BPH is the cause, prostate surgery to relieve obstruction is the single most important step. If neurogenic bladder is the issue, regular clean intermittent catheterisation and specialist bladder management are essential.
Stay Well Hydrated
Adequate fluid intake (aim for 2–2.5 litres of water per day) keeps urine dilute and reduces the concentration of minerals that form stones. Pale straw-coloured urine is a good indicator of adequate hydration.
Catheter Care
If you have an indwelling urinary catheter, regular catheter changes, good hygiene, and adequate fluid intake are important to reduce encrustation and stone formation. Your specialist may recommend periodic bladder washouts.
Follow-Up Monitoring
Regular follow-up with your urologist, including periodic ultrasound or imaging, ensures that any recurrence is detected early and managed promptly before stones become symptomatic or cause complications.
Meet your Specialists
Assessment and treatment of bladder stones is led by our experienced consultant urologists. Your care will be personally overseen by one of our senior specialists.
Key Takeaways
Bladder stones are a common urological condition, particularly in men with bladder outlet obstruction. While they are not typically dangerous, untreated stones can cause persistent symptoms, recurrent infections, and in some cases complete urinary retention.
Modern endoscopic techniques allow most bladder stones to be removed safely through a minimally invasive approach — but they are almost always a sign of an underlying problem. Long-term success depends on treating the cause, whether that is an enlarged prostate, neurogenic bladder, or catheter-related factors. Our team will ensure you receive a thorough assessment and a tailored treatment plan to prevent recurrence and restore normal bladder function.
Further Reading — BAUS Patient Information
Concerned About Bladder Stones?
Book a consultation with our specialist consultant for expert assessment, diagnosis and personalised treatment tailored to your needs.