Bladder Calculi

Bladder Calculi

Hard mineral masses called bladder stones are found in the bladder. When urine in the bladder becomes concentrated, minerals in the urine start to crystallize and form bladder stones. Unable to fully empty bladder frequently results in concentrated, stagnant pee.

Sometimes, small bladder stones will pass on their own, but a doctor may need to remove larger stones. Bladder stones can result in infections and other problems if they are not managed.

Causes

The most common conditions that cause bladder stones include:

• Prostate gland enlargement: An enlarged prostate, or benign prostatic hyperplasia (BPH), can cause bladder stones in men. As the prostate enlarges, it can compress the urethra and interrupt urine flow, causing urine to remain in a bladder.
• Damaged nerves (neurogenic bladder): Normally, nerves carry messages from the brain to bladder muscles, directing bladder muscles to tighten or release. If these nerves are damaged — from a stroke, spinal cord injury or other health problem — bladder may not empty completely.

Other conditions that can cause bladder stones include:

• Inflammation: Bladder stones can develop if bladder becomes inflamed. Urinary tract infections and radiation therapy to the pelvic area can both cause bladder inflammation.
• Medical devices: Occasionally, bladder catheters & slender tubes inserted through the urethra to help urine drain from bladder — can cause bladder stones.
• Kidney stones: Stones that form in kidneys are not the same as bladder stones. They develop in different ways and often for different reasons. But small kidney stones occasionally travel down the ureters into a bladder and, if not expelled, can grow into bladder stones.

Symptoms

Some people with bladder stones have no problems or; even when their stones are large. But if a stone irritates the bladder wall or blocks the flow of urine, signs, and symptoms can develop. This include:

• Lower abdominal pain
• In men, pain or discomfort in the penis
• Painful urination
• Frequent urination
• Difficulty urinating or interruption of urine flow
• Blood in your urine (haematuria)
• Cloudy or abnormally dark-colored urine
• fever with chills
• nausea and vomiting

Pathophysiology

Calcium1-ammonium phosphate (struvite) stones can occur as a result of urinary infection with urea-spitting bacteria (proteus, klebsiella). These bacteria make urine alkaline and are linked to the production of these stones. The bladder may get larger if infectious stones are lodged there. Patients who have an indwelling catheter for a long time frequently develop infected stones.

Tests and diagnosis

• A physical exam. A doctor will likely feel lower abdomen to see if the bladder is enlarged (distended) and, in some cases, perform a rectal exam to determine whether prostate is enlarged.
• Analysis of your urine (urinalysis). A sample of urine may be collected and examined for microscopic amounts of blood, bacteria, and crystallized minerals.
• Spiral computerized tomography (CT) scan. A conventional CT scan combines multiple X-rays with computer technology to create cross-sectional images of the body. A spiral CT speeds up this process, scanning more quickly and with greater definition of internal structures.
• Ultrasound. An ultrasound, which bounces sound waves off organs and structures in the body to create pictures, can help doctor detect bladder stones.
• X-ray. An X-ray of kidneys, ureters, and bladder help doctor determine whether stones are present in a urinary system. But some types of stones aren't visible on conventional X-rays.
• Intravenous pyelography
• Cystoscopy

Treatment

Treatment includes surgical and medical treatment plus nursing management.

Surgical procedure

• Cysto- lithotomy.
• Trans utheral removal of small stones.
• Litholapexy ( crushes the stone then irrigate the bladder to wash out the pieces through a catheter ).

Medical management

• Administration of antibiotics for treatment of UTI.
• Treatment of underlying causes.
• Increase hydration.
• Reduce dietary intake of purine, calcium, and oxalate.

Nursing management

• Examine the child's health and whether any UTI symptoms or signs are present.
• Keep the kid in a cozy environment.
• Utilize prescribed painkillers to manage pain.
• As directed, give antibiotics to prevent infections.
• if surgery is necessary, before and postoperative care;
• encouraging parental knowledge of the intended surgical operation
• Get ready for the required diagnostic process.
• comprehensive preoperative drug regimen.
• Physically prepare the youngster for surgery.
• the parents' participation in child care.
• Encourage healthy urine function by keeping an eye on intake and output while taking care of a drainage tube and urinary catheter.
• Apply a dressing to the surgical site.
• administering an analgesic to control pain following surgery.
• Provide a balanced diet.
• providing games and toys for entertainment.
• Educate parents on the progression of the condition, infection prevention, follow-up, nutritional management, and fluid consumption.