Genitourinary Radiology > Bladder > Calcifications > Bladder Stones

Bladder Stones

Bladder stones occur commonly due to urinary stasis or infection. In the setting of bladder outlet obstruction (such as BPH), uric acid stones predominate. In the setting of urinary tract infection, magnesium ammonium phosphate and apatite stones tend to occur, especially with Proteus infection. While most stones are asymptomatic, symptomatic presentations may include microscopic hematuria, suprapubic pain, or interruption of urine stream.

Stones may be seen on plain film if sufficiently calcified. On cystograms or IVU's, they appear as filling defects because they are usually less dense than contrast-opacified urine. CT imaging shows densely calcified foci.

Unenhanced CT scan of the pelvis in patient with hematuria shows stone material layering in the dependent portion of the bladder (arrows).

Unenhanced CT scan of the pelvis (bone windows on left and soft tissue windows on right) shows laminated stone in the dependent portion of the bladder (S). There are also stones in the proximal urethra (arrows).

Axial CT scan through the pelvis in a patient with chronic urinary stasis problems. Bladder stones are seen in bone windows before (left image) and after (right image) the excretion of contrast material into the bladder. The stones are initially seen as high density foci in the bladder but following contrast excretion the stones are seen as filling defects in the bladder contrast .

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