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Sunday, 1 December 2013

Bladder Stone (Vesical calculi) - The Risk factors

Bladder Stones (calculus) is a composed of mineral masses formed in the bladder as a result of Concentrated, stagnant urinary, dehydrated causes of crystallization. Small bladder stones in most cases, pass on their own in the flow of urine.
Risk factors
1. Cystinuria
Cystinuria is an inherited autosomal recessive disease. There is a report of an unusual cystine stone presented in 24-year-old man. Radiographs showed a giant bladder stone shadow, 8.0 x 10.0 x 5.0 cm in size(10).

2. Age and gender
If you are male and over 30 years of age, you are at increased risk of bladder stone. In the study of a series of 1,354 stones derived from urology departments in Western Algeria was studied by IRTF spectroscopy. Analysis of the results concerned the crystalline composition and anatomical site of the stones and the age and gender of the patients.found that the male/female ratio has remained almost constant at 2.23. The anatomical site has changed with a predominance in the upper tract (77.4% of stones). The nucleus showed that phosphates are predominant in 48.6% of cases versus 35.6% for oxalates. Carbapatite and struvite are more frequent in women, found in 50.8% and 6.7% of cases, respectively, than in man, found in 44.6% and 3.7% of cases, respectively. Calcium oxalate is predominantly found in the upper urinary tract (70.9%) rather than in the bladder (48.3%), regardless of gender. Calcium phosphate is more abundant in the upper tract of females with 23.7% of cases versus 10.7% in the bladder. It is equally distributed between the bladder and the upper tract in males (13.7% and 13.2%, respectively). Examination of the side affected by stones showed a predominance of the left side in both sexes.

4. Bladder outlet obstruction(11)
There is a report of a 48-year-old man was hospitalized with the chief complaints of lower abdominal pain, pain during micturation and pollakuria. Plain radiography showed 2 giant bladder stone shadows: one as 6.0 × 5.0 cm and the other one 5.0 × 5.0 cm in size. That were completely obstructing the bladder outlet and observed several years following pelvic traumahe(12). There are many causes of bladder outlet obstruction but enlarged prostate is one of  primary risk factors.

6. Frequent bladder infections
Chronic bladder infections can lead to the formation of bladder stones.

7. Urinary track infection
Urinary tract infection can cause obstruction of the urinany flow that can lead to formation of bladder stone. Urinary tract bacterial infections are common in women. Moreover, they tend to recur throughout life and in the same relatively small group of women. In most cases, bladder and renal infections are asymptomatic and manifest by demonstrating coincidental bacteriuria. In some instances, however, especially with frequent sexual activity, pregnancy, stone disease, or diabetes, symptomatic cystitis or pyelonephritis develops and antimicrobial therapy is indicated(13)

8. Nutritional factors
In teh study to describe clinical cases of childhood bladder stones and associated risk factors. Forty children (9 girls), aged 1-14-years old, (means 4.7 +/- 0.5 years), who underwent surgical stone removal in the Saravane Provincial Hospital during a 13-month period, researchers at the Institut de la Francophonie pour la Médecine Tropicale, showed that  the morbidity and social cost of childhood bladder stones may be high. A larger scale prospective and comparative study assessing their incidence and associated nutritional factors is warranted and feasible, and may lead to preventive measures(14).

9. Etc.
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Sources
(10) http://www.ncbi.nlm.nih.gov/pubmed/15198153
(11) http://www.ncbi.nlm.nih.gov/pubmed/16821346
(12) http://www.ncbi.nlm.nih.gov/pubmed/21806900
(13) http://www.ncbi.nlm.nih.gov/pubmed/16260529
(14) http://www.ncbi.nlm.nih.gov/pubmed/15906634