Bladder Stone?

[kmelinda]

Since being injured in 1984, I've developed my first bladder stone. It's the size of a nickel. My urologist plans on attempting to remove it with a cystoscope within a month. That's currently being scheduled.
She says, as long as it's still soft, she will be able to do it with the cystoscope in the clinic. If not, it'll mean it being removed surgically under anesthesia.

I don't know much about these stones. I'm curious if the suprapubic catheter I had done last fall could be the cause. I initially intermittent cathed for years. Then, wore an indwelling Foley through my urethra for the past few years

I'd appreciate any advice on preventing any other stones, and even how I might could naturally rid myself of the current stone.

Thanks,
Karen

[gjnl]

Since being injured in 1984, I've developed my first bladder stone. It's the size of a nickel. My urologist plans on attempting to remove it with a cystoscope within a month. That's currently being scheduled.
She says, as long as it's still soft, she will be able to do it with the cystoscope in the clinic. If not, it'll mean it being removed surgically under anesthesia.

I don't know much about these stones. I'm curious if the suprapubic catheter I had done last fall could be the cause. I initially intermittent cathed for years. Then, wore an indwelling Foley through my urethra for the past few years

I'd appreciate any advice on preventing any other stones, and even how I might could naturally rid myself of the current stone.

Thanks,
Karen

Probably little chance of eliminating the current stone by any means but what your doctor has recommended. That said, I recently had a cystoscopy, and my urologist did the procedure in the hospital under anesthesia. You may want to inquire about this.

I don't think having a supra pubic catheter puts you at more risks of stones than any other bladder management.

[SCI-Nurse]

Actually indwelling catheters (both SP and urethral) do increase your risk for bladder and other urinary stone development.

Is your urologist planning on using a laser to break up the stone (which is state-of-the-art) or crush it mechanically? Both can be done with cystoscopy. If you are subject to autonomic dysreflexia, anesthesia may still be needed for a cystoscopic procedure.

(PS: Please consider completing your profile. Knowing your level of SCI is helpful in offering advice on issues such as autonomic dysreflexia risks.)

(KLD)

[kmelinda]

I've had cystoscophies done in the past to check inside my bladder without having any AD issues. Do you think this will be different in more likely to cause AD? My doctor didn't mention how she planned to break it up...just we're hoping it's still new and soft so it doesn't require putting me under general anesthesia. As you know, my C3/4/5 injury makes that high risk of getting back off the ventilator and the risk of pneumonia.

[SCI-Nurse]

Spinal anesthesia is commonly used to prevent AD during cystoscopy, so general anesthesia is rarely needed.

If you have had cystoscopy before without AD, it is unlikely it should occur with this one, but your blood pressure should be constantly monitored during the procedure, and a plan made for management PRIOR to the procedure.

(KLD)

[gjnl]

Actually indwelling catheters (both SP and urethral) do increase your risk for bladder and other urinary stone development.
(KLD)

It would be unfortunate if someone dismissed managing their bladder with an indwelling catheter because of a perceived greatly increased risk of bladder stones. A study like this puts the use of indwelling catheters into perspective. Use of indwelling catheters, age, history of infections with urease producing bacteria, and complete injuries, (and possibley gender) all together increase the risk of bladder stone formation. Indwelling catheter use is but one factor, and a very small factor at that. I had a urologist, who diminished the risk of developing bladder stones in spinal cord injured with, "some people are bladder stone makers and others aren't, spinal cord injured or general population." Maybe he was too dismissive, but there is probably some truth to his thought.

https://www.ncbi.nlm.nih.gov/pubmed/15478528

J Spinal Cord Med. 2004;27(3):252-4.
Factors influencing bladder stone formation in patients with spinal cord injury.

Favazza T1, Midha M, Martin J, Grob BM

Abstract

OBJECTIVE:

Bladder stones that form in patients with spinal cord injury (SCI) can cause significant morbidity. This study sought to analyze factors associated with bladder stone formation to determine which patients might be at increased risk to develop bladder stones.
METHODS:

A review of 56 SCI patients treated for bladder calculi over a 10-year period at a single institution was performed. These patients were compared with a control population of general SCI patients known to be stone free. The factors compared were patient age, duration of injury, level of injury, completeness of injury, method of bladder management, and the presence of documented urinary tract infections with urease-producing organisms.
RESULTS:

All patients with stones were male and had a median age of 58.5 years. The median level of injury was C6, the median time since injury was 21 years, 66% had complete injuries, 68% managed their bladders with indwelling catheters or suprapubic tubes, and 83% had a history of infections with urease-producing organisms. When compared with the control group, patients forming bladder stones were older (P = 0.03), were more likely to have indwelling catheters (P < 0.0001), had a history of infections with urease-producing organisms (P = 0.04), and had complete injuries (P = 0.018).
CONCLUSION:

This information can be used to identify patients who have an increased risk of bladder stones and measures can be taken to reduce their incidence and morbidity.

[alan]

I just had three bladder stones set by lasers ( lithotripsy) in September (first bladder stones I ever had.) My urologist said they were pretty big, but he had no problem dealing with them. I watched the procedure as it was going on. Pretty neat.

[kmelinda]

This is my first too. Ummm was this done in clinic, how was the procedure done with a laser, and were you under any type of spinal block, local, etc anesthesia?

[alan]

This is my first too. Ummm was this done in clinic, how was the procedure done with a laser, and were you under any type of spinal block, local, etc anesthesia?

This was outpatient, done in the clinic. I was sedated, and there was also local anesthesia.

[August West]

My doctor prescribed Potassium citrate to help prevent kidney stones.

[CapnGimp]

my history pics included

KLD posted this in 2004...
http:///forum/showthread.php?23421-B...atients-(2003)

I have had stones removed a few times starting in 1999, the last was 2016 when I started using Duette dual balloon catheters to reduce clogging/blockage. I will post a picture that was taken in 2014 when I had a couple of big ones removed(described as tennis ball size added together), didn't get pics of any of the others. The 2016 trip was done with lasers and if I can find the paperwork sometime, I will get the size. For some reason, they always put me under in the hospital. I can't feel a thing and do not get AD, since one time in rehab. I have 'grit' built up on the end of my catheters every time I remove them. I change them about 2-3 times per month. Hydration makes a big difference in discharge rates of sediments, 'slime', etc. The closer to clear I keep my urine in the leg bag, the less often they show up. For the record, I do not eat any animal products and avoid sugars like the plague, unless it occurs naturally in the fruits I eat. When I was eating animal products and sugars, it was WAY worse, that is when I produced the 'tennis ball' sized ones.

[SCI-Nurse]

My doctor prescribed Potassium citrate to help prevent kidney stones.

There is no evidence that this medication (Urocit-K) decreases stone development in people with SCI. It is primarily used for AB people who have a genetic predisposition to be "stone formers". It also only helps with calcium stones, not the struvite stones that commonly form in people with SCI.

Some urologists prescribe acetohydroxamic acid (Lithostat) for struvite stones that cannot be surgical removed.

(KLD)

[CowboyCrip]

Just thought I'd share my experience 30 years as c 5-6. Had bladder stones removed twice. First was 10-12 years ago and "crushed and flushed" via claw on cysto. No anesthetic needed. Unless they used topical - I don't know. Annual cystoscope I undergo never bothers me.

This past summer, had it done again - but now they use a fancy-shmacy laser. Thankfully my anesthetist was amazing and she had the forethought to prepare for immediate intervention if needed. It was needed. They no sooner began inserting and my bp shot up dangerously high. Moral of he story - If they use a laser - You need Anesthetic.

[August West]

There is no evidence that this medication (Urocit-K) decreases stone development in people with SCI. It is primarily used for AB people who have a genetic predisposition to be "stone formers". It also only helps with calcium stones, not the struvite stones that commonly form in people with SCI.

Some urologists prescribe acetohydroxamic acid (Lithostat) for struvite stones that cannot be surgical removed.

(KLD)

That's interesting. How about uric acid stones? That's what I had removed surgically. Maybe now that I am Stone Free I can do whatever I please. I can ride the breeze.

[SCI-Nurse]

That's interesting. How about uric acid stones? That's what I had removed surgically. Maybe now that I am Stone Free I can do whatever I please. I can ride the breeze.

Stones can easily reoccur, in fact once you have had stones, it is very likely that you will have them again. Potassium citrate or sodium bicarbonate and lots of fluids (at least 3 liters of water daily) are recommended for prevention of uric acid stones as well as calcium stones. Uric acid stones form less readily in alkaline urine.

(KLD)