Bladder Stones Secondary to Chronic Urinary Obstruction
Semir A. S. Al Samarrai
The composition, etiology and age distribution of the patient with bladder calculi varies around the world. The predominant cause of bladder calculi is bladder outlet obstruction.
In the Middle East countries, where malnutrition is more rampant adults are the ones primarily afflicted with bladder stones, however, children are also affected. When the patients with obstructive symptoms were studied with intravenous pyelogram or ultrasound in large series, 2.7-3.2 percent of the population was found to have bladder stones.
The chief complaints of this disease are urinary intermittence, lower abdominal discomfort, urinary stream stops abruptly and then resumes, and there is also dysuria because of the usual presence of urinary tract infection by this patients.
Treatment of bladder calculi has two main goals: first, to completely remove all the stone material; second, to correct the defect that defect that causes the stone to form. I think that in the case of bladder stones recurrence, the aforementioned second goal of treatment namely to correct the defect that causes the bladder stones has not been performed.
The case of bladder outlet obstruction by women is mostly anterior urethral mass such as cystocele, gartner's duct cyst, vaginal inclusion cyst or urethral or bladder diverticulum or meatus stenosis of the urethra. The cause of bladder outlet obstruction by man is mostly benign prostatic hyperplasia.
In addition to open surgery, there are numerous endoscopic methods available for stone removal such as, laser or electro hydraulic lithotripsy. Endoscopic techniques can be performed under local anesthesia or intravenous sedation.
Once the patient has been rendered stone free, the underlying cause of stone formation should be identified and corrected.
Correspondence:Prof. Dr. SEMIR AHMED SALIM AL SAMARRAI
Professor Doctor of Medicine-Urosurgery, Andrology, and Male Infertility
Dubai Healthcare City, Dubai, United Arab Emirates.
Mailing Address: Dubai Healthcare City, Bldg. No. 64, Al Razi building, Block D,
2nd floor, Dubai, United Arab Emirates, PO box 13576