What Happens When a Kidney Stone Gets Stuck in the Bladder?

When a kidney stone enters the bladder, many people assume it will pass easily. However, some stones may get lodged in the bladder, especially if they are large, irregularly shaped, or if bladder emptying is impaired.

A stone lodged in the bladder can lead to urinary symptoms and pain, and in some cases, an infection. Read ahead to know why stones get stuck, clinical symptoms, how clinicians diagnose the issue, and the treatment options doctors typically consider.

Quick Answer: Impact of Bladder-trapped Kidney Stones

Small kidney stones usually pass through urine; however, larger or chronic stones might need medical intervention. When the kidney stone is large, irregularly shaped, or when one has a problem in emptying the bladder, the stone may get stuck in the bladder. While some stones cause no symptoms, others may lead to:

• Frequent urge to urinate
• Burning sensation
• Lower abdominal pain
• Difficulty passing urine
• Blood in urine

Why a Kidney Stone May Get Stuck in the Bladder

Once a stone reaches the bladder, its ability to exit through the urethra depends on both its size and the health of the lower urinary tract. Here are a few factors that determine whether or not a stone may pass:

1. Stone Size Exceeds Urethral Diameter

Many stones smaller than 4-5 mm pass naturally, but stones bigger than 7 mm might not exit with ease, particularly in men due to the longer length of the male urethra with narrow segments like the bulbar urethra, and the membranous urethra.

2. Weak Bladder Emptying

Dr Vishal highlights that medical conditions that reduce bladder contraction (detrusor underactivity) or obstruct urine flow may also allow stones to settle and become stuck. These are caused due to:

• Enlarged prostate (BPH): Neurogenic bladder, e.g. spinal injury, nerve damage caused by diabetes, etc.
• Bladder alterations after surgery
• Chronic urinary retention

3. Stone Shape and Composition

Some stones have irregular, spiky, or crystalline surfaces, making them more likely to irritate or catch against the bladder mucosa (the innermost lining of the bladder).

4. Frequent Urinary Infections

Infections may change bladder function and promote the formation of struvite stones, which are infection-induced kidney stones composed of magnesium ammonium phosphate that grow relatively fast.

Symptoms of a Kidney Stone Stuck in the Bladder

Although the symptoms vary depending on the size of the stone, mobility, and infection, some common symptoms include:

• Frequent or Urgent Urination: Stones irritate the bladder lining, which causes sensitivity and a frequent or urgent urge to urinate.
• Burning or Stinging During Urination: Inflammation of the bladder wall due to stones feels like cystitis irritation that most people observe during urination.
• Abdominal Pain: Stones lead to a sharp or dull pain in the lower abdomen, usually above the pubic bone.
• Difficulty Passing Urine: A stone may temporarily block the bladder outlet, making it difficult for urine to pass.
• Interruption of the Urine Stream: Stones also interrupt the flow of urine; however, it resumes once the stone passes.
• Cloudy or Strong-Smelling Urine: Often linked to a Urinary Tract Infection (UTI), but kidney stones also lead to cloudy or foul-smelling urine.

Potential Complications if the Stone Remains Stuck Too Long

According to the American Urological Association, when a stone is left in the bladder over a long period of time, it can cause the following complications:

• Recurrent UTIs: Recurrent UTIs, which may contribute to chronic bladder inflammation (chronic cystitis)
• Worsening urinary retention: The deposition of minerals on the existing stone can increase the stone size, which in turn can worsen urinary retention.
• Thickening of the bladder: Although rare, chronic irritation may at times cause other complications, such as thickening of the bladder, which needs to be medically assessed.

Treatment Options for a Stone Stuck in the Bladder

The treatment and management of kidney stones mainly depend on stone size, symptoms, and whether the bladder is obstructed.

1. Conservative Management: Watchful Waiting

The conservative management of nephrolithiasis is usually recommended when:

• The stone is less than 4-5 mm
• No infection is present
• Symptoms are mild

During the watchful waiting, doctors may recommend:

• Improved fluid consumption
• Pain relievers
• Monitoring symptoms

2. Medications

Medications are used depending on the cause:

• Antibiotics for confirmed infections
• Pain relief (as prescribed)
• Medications for prostate enlargement or bladder dysfunction
• “Alpha-blockers (like tamsulosin) have limited usefulness for bladder stones but may be selectively used if urethral relaxation is expected to help passage,” Dr Vishal shares.

3. Cystolitholapaxy

Cystolitholapaxy is the most common treatment for kidney stones. It is a minimally invasive surgery in which:

• The bladder is introduced to a cystoscope
• The stone is broken by laser or mechanical means
• Fragments are either removed or passed naturally

Dr Vishal affirms, “Recovery is typically quick, which thus makes it an ideal treatment for larger stones.”

4. Treatment of the Underlying Cause

Studies published in Informed Health indicate a 50% chance of recurrence within 5 to 10 years for someone who has already had a stone. Therefore, to prevent recurrence of kidney stones, doctors may address:

• Prostate enlargement
• Bladder emptying issues
• Long-term catheter-related complications
• Chronic infections

When to Seek Urgent Medical Care

Seek immediate medical care if you notice any of the following symptoms, because they may indicate infection:

• Fever or chills
• Inability to pass urine
• Severe lower abdominal pain
• Persistent blood in urine
• Worsening urinary symptoms

How To Lower the Risk of Future Bladder Stones

If you are prone to stones, here are some ways to lower the risk of future bladder stones:

1. Hydration

Adequate water intake is one of the most recommended ways to avoid kidney stones. According to the US Southwestern Medical Center, sufficient fluid intake helps in diluting urine, reducing the concentration of crystal-forming minerals like calcium and oxalate.

2. Fully Emptying the Bladder

Techniques like double voiding may help some individuals. Mayo Clinic defines double voiding as a behavioural technique people use to ensure that their bladder empties completely, reducing urinary frequency, urgency, and the risk of infections.

3. Addressing Prostate or Bladder Conditions

Regular monitoring and timely treatment reduce the retention of kidney stones in the bladder.

4. Dietary Adjustments

Dr Vishal highlights that based on stone type, your doctor may recommend:

• Limiting high-oxalate foods (particularly for calcium oxalate stones)
• Moderating sodium
• Ensuring balanced calcium intake

Bottomline

Kidney stones in the bladder may cause urinary symptoms, pain and in some cases infection. Most of the small stones pass naturally, but larger stones or stones that are related to urinary retention mostly require medical intervention. Experts say that early diagnosis can help in avoiding complications and giving proper treatment.