Bladder stones

Stones forming in a bladder that does not empty. Almost always a symptom of an outflow problem rather than a problem in itself.

What it is

Hard mineral deposits forming in the bladder, quite distinct from kidney stones, which form higher up and pass down.

They form in urine that sits in the bladder rather than being emptied out, so they are almost always a consequence of something else: an enlarged prostate, a neurological bladder in spinal cord injury, multiple sclerosis or spina bifida, a long-term catheter, or a bladder that does not contract properly.

That is the practical point: removing the stone without addressing why the bladder is not emptying guarantees another one.

They are much more common in men over 50, and in anybody with a long-term catheter, where encrustation and stone formation is a recurring problem.

Long-standing bladder stones and chronic catheter irritation are associated with a rare type of bladder cancer, which is one reason not to simply live with them.

They cause pain, blood in the urine, infection, and sometimes sudden interruption of the stream as a stone blocks the outlet.

Signs you might notice

Lower abdominal pain, sometimes severe, and pain at the tip of the penis.

A urine stream that starts and stops suddenly, or interrupted flow.

Difficulty passing urine, or needing to change position to go.

Blood in the urine.

Cloudy, dark or foul-smelling urine.

Frequent urinary tract infections.

Urgent: inability to pass urine at all, which is urinary retention and needs same-day help.

Same-day: fever with loin or lower abdominal pain, suggesting infection.

For catheter users: repeated blockages, bypassing around the catheter, or blood, all of which suggest stones or encrustation.

How it can affect day-to-day life

For catheter users this is a recurring practical problem. Encrustation blocks catheters, causes bypassing and leads to repeated changes and infections. A catheter valve, adequate fluids, and planned changes before the usual blockage interval all reduce it.

The underlying question is always whether the catheter is still needed. Long-term catheters cause stones, infections and cancer risk, and reviewing the need for one is a genuine intervention.

In men with prostatic obstruction, treating the prostate is what prevents recurrence.

Bladder scans are quick and non-invasive and show residual urine after voiding, which is the measurement that identifies incomplete emptying. They are under-used in primary care.

Fluid intake matters, and older people often restrict fluids because of continence worries, which concentrates urine and worsens stone formation.

Supporting someone well

Ask why the bladder is not emptying, not just for the stone to be removed.

Ask for a post-void bladder scan; it takes seconds and identifies the underlying problem.

Treat prostatic obstruction, or review bladder management in neurological conditions.

Keep fluid intake up rather than restricting it for continence reasons; discuss continence separately.

For catheter users, ask whether the catheter is still needed, and if so ask about valves, planned changes and washouts.

Get inability to pass urine seen the same day.

Report repeated infections rather than accepting them as inevitable.

Ask about surveillance where a catheter has been in place for many years.

Where to get help

A GP practice for symptoms and a bladder scan; urology for treatment.

Same-day help for inability to pass urine or fever with pain.

The continence service for catheter and bladder management.

Bladder Health UK run a helpline and cover bladder conditions and catheter care.