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Tests and diagnosis
By Mayo Clinic staffMaking a diagnosis of bladder stones begins with a physical exam. Your doctor will likely feel your lower abdomen to see if your bladder is distended and, in some cases, perform a rectal exam to determine whether your prostate is enlarged. You may also discuss any urinary signs or symptoms that you've been having.
Other tests used to make a diagnosis of bladder stones may include:
- Urinalysis. A sample of your urine may be collected and examined for microscopic amounts of blood, bacteria and crystallized minerals. A urinalysis is also helpful for determining whether you have a urinary tract infection, which can cause bladder stones.
- Cystoscopy. During cystoscopy, your doctor inserts a tube with a small camera at the end (cystoscope) through your urethra and into your bladder. After the cystoscope is in place, your doctor fills the cystoscope with water, which flows into your bladder. As fluid fills your bladder, it stretches the bladder wall, allowing your doctor to view the bladder interior. Cystoscopy is the most sensitive test for diagnosing bladder stones because it helps your doctor see the number, size and location of the stones in your bladder.
- Spiral computerized tomography (CT) scan. A conventional CT scan combines multiple X-rays with computer technology to create cross-sectional images of your body rather than the overlapping images produced by regular X-rays. A spiral CT speeds up this process, scanning more quickly and with greater definition of internal structures. Spiral CTs can detect even very small stones and are considered one of the most sensitive tests for identifying bladder stones of all types.
- Ultrasound. An ultrasound, which bounces sound waves off organs and structures in your body to create pictures, can help your doctor visualize bladder stones.
- X-ray. An X-ray of your kidneys, ureters and bladder helps your doctor determine whether stones are present in your urinary system. This is an inexpensive and easy test to obtain, but some types of stones aren't visible on conventional X-rays.
- Intravenous pyelogram. An intravenous pyelogram is a test that uses a contrast material to visualize organs in your urinary tract. The material is injected into a vein in your arm and flows into your kidneys, ureters and bladder, outlining each of these organs. X-ray pictures are taken at specific time points during the procedure to check for stones. In many cases, helical CT scans have now replaced this test.
References
- Managing bladder dysfunction. Clinical Center: National Institutes of Health. http://clinicalcenter.nih.gov/ccc/patient_education/pepubs/bladder/bladder7_9.pdf.Accessed Oct. 4, 2008.
- Weinstein AJ. Urinary calculi (stones/urolithiasis/nephrolithiasis). In: Weber CG. The Clinical Medicine Consult. Pacific Primary Care; 2008. http://clinicalmedconsult.com. Accessed Oct. 4, 2008.
- Pearle MS, et al. Urologic diseases in America: Urolithiasis. National Kidney and Urologic Diseases Information Clearinghouse.http://kidney.niddk.nih.gov/statistics/uda/Urolithiasis-Chapter08.pdf. Accessed Oct. 4, 2008.
- Medical management of stone disease. American Urological Association. http://www.urologyhealth.org/search/index.cfm?topic=102&search=bladder%20AND%20stones&searchtype=and. Accessed Oct. 4, 2008.
- Hammad FT, et al. Bladder calculi: Did the clinical picture change? Urology. 2006;67(6):1154-1158.
- Garcia Cardozo JV, et al. Bladder calculi: Is extracorporeal shock wave lithotripsy the first treatment choice? Archives of Spanish Urology. 2003;56(10):1111-1116.
- Gravel root. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Oct. 5, 2008.
- Stone root. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Oct. 5, 2008.
- Hydrangea arborescens. Natural Medicines Comprehensive Database. http://www.naturaldatabase.com. Accessed Oct. 5, 2008.
- Ellis H. A history of bladder stone. Journal of the Royal Society of Medicine. 1979;72(4):248-251.
