Stone removal surgeries - bladder stones

How do bladder stones form?

Urinary stones often form when the flow of urine from the bladder is obstructed. If urine remains in the bladder for too long (urinary retention), the mineral salts it contains can precipitate, leading to stone formation over time.

Obstructed urination may be caused by the following:

• enlarged prostate (benign prostatic hyperplasia, BPH)
• urethral stricture
• bladder paralysis (bladder atony)
• presence of a foreign body (such as a bladder catheter)
• bladder diverticulum
• in women, bladder prolapse (cystocele)

The following factors may increase the risk of developing bladder stones:

• urinary tract infections (cystitis, chronic bacterial infections)
• foreign bodies in the bladder, such as a catheter/DJ catheter, non-absorbable surgical sutures
• inadequate fluid intake
• bladder innervation disorder (neurogenic bladder)
• certain metabolic disorders, such as gout, hyperparathyroidism, kidney stones
• bladder damage after radiation therapy

The presence of bladder stones may be accompanied by the following symptoms:

• frequent urination
• painful urination (dysuria)
• bloody urine (hematuria)
• weak urine stream or urinary retention, especially if the stone is blocking the urethra

In what cases is stone removal surgery necessary?

In many cases, bladder stones do not cause any symptoms, and in the case of smaller stones, they can be spontaneously passed out of the body during urination. However, if the stones are too large to pass naturally or block the urethral outlet, they may require surgical removal. The goal of bladder stone removal is to restore normal urine flow, preserve bladder function, prevent bladder damage, relieve symptoms and improve quality of life.

Removing the bladder stone does not eliminate the cause of the formation of the bladder stone. To prevent the recurrence of bladder stones, it is essential to properly treat the underlying disease that led to their formation.

What preliminary tests are required?

Before stone removal surgery, in addition to a urological examination, a laboratory test and an anesthesiology consultation are required.

How is bladder stone removal conducted?

If the presence of bladder stones is confirmed, the choice of the appropriate surgical method depends on the size of the stone and the patient’s general condition. Removal of bladder stones is usually done through the urethra (transurethral), endoscopically, either using a laser or a mechanical bladder stone crushing device. Only in rare cases, especially in the case of large stones, is open surgical removal necessary.

The procedure is performed under regional anesthesia or general anesthesia. The two methods of removal are as follows.

• Removal through the urethra (transurethral surgery)

During the surgery, an optical inspection device (resectoscope) is introduced through the urethra into the bladder. During the procedure, a laser or a mechanical stone crusher is used to break up the stones. The resulting stone debris is washed out of the bladder with the help of liquid. After the procedure, it may be necessary to insert a urethral catheter to ensure the flow and drainage of urine.

• Open surgical removal (cystolithotomy, abdominal incision procedure)

Open surgical removal of bladder stones is now only performed in very rare cases, mainly in the case of very large stones. The surgeon makes an incision in the lower abdomen, then opens the bladder and removes the stone. At the end of the operation, both the bladder and the abdominal wound are repaired in layers. At the end of the procedure, a urethral catheter is usually inserted for a few days to ensure proper drainage of urine.

Advantages of endoscopic stone removal

Endoscopic procedures are less invasive because they do not require an abdominal incision. Patients recover faster and have less pain. There is also a lower risk of bleeding and complications, making them safer for older patients or those with chronic conditions.

However, for larger stones, endoscopic surgery can be significantly more time-consuming, which increases the risk of complications. Due to the long duration of this surgery, anesthesia can also be a greater burden for the patient. In such cases, open surgical stone removal may be a simpler and more effective solution.

Advantages of laser stone surgery

• Greater precision – the laser leaves less debris, making removal more effective and reducing the chance of stone recurrence.
• Lower risk of infection – shorter catheter wear time reduces the development of urinary tract complications.
• Can be combined with other urological procedures – for example, treatment of prostate enlargement can be performed during the same surgery, thus preventing the formation of new stones.

What should the patient do after stone removal surgery?

After surgery, the patient usually needs an overnight hospital stay, but in the case of open surgery, a longer stay may be necessary. The urethral catheter inserted after surgery is usually removed after 1-3 days. Pain relief and antibiotic treatment may also be necessary, as directed by your doctor. It is recommended to drink at least 2-3 liters of fluid per day to dilute the urine and flush the bladder. Gentle exercise is recommended for a few days after surgery, but heavy physical exertion (e.g., lifting, sports) should be avoided for at least 2-4 weeks. To prevent the stones from recurring, it is important to treat the underlying cause and follow an appropriate diet.

What are the risks of stone removal surgery?

After the surgery, traces of blood may appear in the urine, which will gradually clear up over a few days. Frequent urination and a slight burning sensation during urination may occur, which will disappear within a few days. Postoperative bleeding, irritative complaints and urinary retention problems may also occur, but these are typically temporary. Inflammatory complications, hospital infections and deep vein thrombosis may occur, the chances of which are minimal if the appropriate protocols are followed.

Stone removal surgery fees

You can find our current fees under our prices menu.

WHY CHOOSE DR. ROSE PRIVATE HOSPITAL?

• Highly trained specialists, modern diagnostic and therapeutic equipment.
• Empathetic, people-centered approach. Our specialists always keep the comfort and safety of our patients in mind.
• Premium inpatient department. Available to our patients are 3 operating theaters and 24 patient rooms with 33 beds to meet all needs. The highest professional standards are combined with an exclusive environment that aids recovery in safety and with complete peace of mind.
• Fast and predictable appointments. We provide an appointment for the necessary intervention within 1-2 weeks of the first specialist consultation.

For any urological complaints, please contact the doctors at Dr. Rose Private Hospital with confidence.