Bladder stones

Introduction Bladder stones are stones formed in the bladder that can be divided into primary bladder stones and secondary bladder stones. The former refers to the stones formed in the bladder, mostly caused by malnutrition, and often occurs in children. With the continuous development of China's economy, children's bladder stones have shown a downward trend. The latter refers to bladder stones originating from the upper urinary tract or secondary to lower urinary tract obstruction, infection, bladder foreign body or neurogenic bladder. In economically developed areas, bladder stones mainly occur in older men, and More suffering from benign prostatic hyperplasia or urethral stricture. In poor areas, it is more common in children, and women are rare.

Cause

In addition to malnutrition factors, lower urinary tract obstruction, infection, bladder foreign body, metabolic diseases can be secondary to bladder stones, lower urinary tract obstruction such as benign prostatic hyperplasia, urethral stricture, bladder neck tumor, etc., are easy to stay due to urine Inducing the formation of bladder stones, bladder foreign bodies such as catheters, sutures, etc., can be used as the core, secondary to the formation of bladder stones, in addition, in the epidemic area of schistosomiasis in Egypt, bladder stones with egg as the core can be seen.

an examination

The symptoms of bladder stones are mainly dysuria, dysuria and hematuria, but there are also a few cases, especially those with lower urinary tract obstruction and residual urine. Stones are sometimes large but asymptomatic.

Bladder stones are mainly based on medical history, physical examination, B-ultrasound, X-ray, and sometimes CT diagnosis, sometimes through cystoscopy to help diagnose. The B-ultrasound stones appear as strong echoes with sound and shadow, which can move with the body position. X-rays need to be urinary flat films, and negative stones can be diagnosed by CT scan.

Differential diagnosis

Bladder foreign body

Foreign body in the bladder can cause difficulty in urinating, urinary frequency, urinary urgency, and hematuria. There is a history of bladder foreign body implantation, but more cover up the medical history, you need to ask carefully. Cystoscopy is the main means of identification. It can directly see the nature, shape and size of foreign bodies. The plain film in the bladder area has differential diagnostic value for opaque foreign bodies.

2. Prostatic hyperplasia

Prostatic hyperplasia has difficulty urinating and painful urination. The difference is that it occurs in the elderly, and the history of dysuria is long and gradually worsened. The urinary line was fine and weak, and it gradually became dripping so that urinary retention occurred. It is not like bladder stones, which is a sudden pain when urinating in the middle of the urine. The flat area of the bladder area has no opaque shadows. Cyst angiography showed a negative shadow of the bladder neck into the bladder, and the bladder neck was elevated. The rectal examination can touch the hyperplasia of the prostate into the rectum, and the middle groove disappears.

3. Posterior urethral valve

It is common in children with dysuria, and there is no opaque shadow in the plain area of the bladder. However, the urethra of the urinary tract is seen to increase the urethra above the valve, and the urethra below the valve is normal. Urethroscopy can be seen in the posterior urethra as a valve-like diaphragm, mostly on the anterior wall. Cystoscopy revealed no stones in the bladder.

4. Urethral stones

Urethral calculi are mainly from the upper urinary tract, and are invaded in the urethra. There are dysuria, painful urination, interruption of urination and obstruction. Urethral calculi are often embedded in the posterior urethra and the scaphoid fossa, which can be touched with metal probes and can be hit by stones. The anterior and posterior urethral and oblique slices can be seen as opaque shadows that are round or oval, generally as large as peanuts.

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