Dr Brendan Dias

Key Points

Bladder stones are hardened mineral deposits that form when urine remains in the bladder too long. They cause pain, frequent urination and blood in the urine, and are usually treated with cystolitholapaxy — a telescope procedure that breaks and removes the stone.

Bladder stones most often form because the bladder does not empty completely — commonly due to an enlarged prostate (BPH), urethral stricture or a nerve-related bladder problem.
Typical symptoms include lower abdominal pain, pain or burning when passing urine, frequent urination, interrupted flow, and blood in the urine.
Diagnosis is usually made with an ultrasound or CT scan; flexible cystoscopy lets the urologist look directly inside the bladder.
Cystolitholapaxy — passing a telescope through the urethra and breaking the stone with a laser or pneumatic device — is the standard treatment for most bladder stones.
Treating the underlying cause (such as HoLEP for an enlarged prostate) is essential to prevent stones from recurring.
Small stones may pass on their own, but most bladder stones need surgical removal because they rarely pass through the urethra spontaneously.

Written and clinically reviewed by Dr Brendan Dias

Consultant Urologist & Robotic Surgeon · MBBS, MS (General Surgery), DrNB (Urology), IntFRCS (England), FUSANZ, FRACS (Urology)

Last clinically reviewed: 6 August 2026

What are bladder stones?

Bladder stones (vesical calculi) are hard masses of minerals that form inside the bladder. They develop when urine becomes concentrated and sits in the bladder for too long, allowing minerals to crystallise. Unlike kidney stones, which form in the kidney and may travel down, bladder stones usually form in the bladder itself — and their presence almost always points to an underlying problem with bladder emptying.

Why do bladder stones form?

The single most important factor is incomplete bladder emptying. Common causes include:

Enlarged prostate (BPH) — the most common cause in men. The prostate obstructs the bladder outlet, leaving residual urine behind. Learn more about HoLEP for enlarged prostate.
Urethral stricture — narrowing of the urethra that blocks urine flow.
Neurogenic bladder — nerve damage (from spinal cord injury, diabetes, stroke or multiple sclerosis) that prevents the bladder from emptying properly.
Bladder diverticula — pouches in the bladder wall where urine pools and stagnates.
Long-term catheters or foreign bodies — stones can form on any surface that stays in the bladder.
Kidney stones that drop into the bladder — a small stone that passes from the kidney can grow in the bladder if it is not passed.

Symptoms of bladder stones

Some bladder stones cause no symptoms and are found incidentally on a scan. When symptoms occur they typically include:

Pain or discomfort in the lower abdomen or penis
Pain, burning or stinging when passing urine
Needing to urinate more often, including at night
A urine stream that stops and starts (interrupted flow)
Blood in the urine (haematuria)
Cloudy or dark urine, or recurrent urinary tract infections

Men with these symptoms should be assessed promptly — particularly if there is visible blood in the urine, which always warrants investigation. Read more in Blood in Urine — When to Worry.

How are bladder stones diagnosed?

Diagnosis usually starts with an ultrasound or a CT scan, which show the size, number and position of stones, as well as any prostate enlargement or bladder diverticula. A flexible cystoscopy — a thin telescope passed through the urethra under local anaesthetic — allows direct inspection of the bladder and confirms the diagnosis. Urine tests check for infection, and blood tests assess kidney function.

Treatment options

Cystolitholapaxy (telescopic stone removal)

This is the standard treatment for most bladder stones. Under general or spinal anaesthetic, a telescope is passed through the urethra into the bladder. The stone is broken into small fragments using a holmium laser or a pneumatic (jackhammer-like) device, and the fragments are washed out. It is usually a day procedure, and most patients go home the same day, sometimes with a catheter overnight.

Treating the underlying cause

Removing the stone alone is not enough — if the reason it formed is not addressed, stones return. For men with an enlarged prostate, HoLEP (laser prostate enucleation) can be performed at the same operation as the stone removal, clearing both problems in one anaesthetic. Urethral strictures may need optical urethrotomy or urethroplasty.

Open or percutaneous surgery

Very large stones (typically over 4–5 cm), stones in children, or stones combined with bladder diverticulum surgery may require removal through a small incision. This is uncommon today.

Recovery and prevention

Most patients recover from cystolitholapaxy within a few days. Some blood in the urine and stinging on urination is normal for a week. To prevent recurrence, it is important to treat the underlying cause, drink enough fluid to keep urine dilute, and attend follow-up imaging as advised.

Frequently asked questions

Can bladder stones pass on their own?

Very small stones occasionally pass through the urethra, but most bladder stones are too large or the bladder outlet too obstructed for this to happen. The majority require telescopic removal.

Are bladder stones dangerous?

Untreated bladder stones cause recurrent infections, bleeding, bladder wall damage and can obstruct urine flow entirely. They should not be ignored.

Will the stones come back?

Recurrence is common if the underlying cause is not corrected. When bladder emptying is restored — for example after HoLEP for BPH — recurrence rates are low.

Assessment and treatment in Melbourne

Dr Brendan Dias, urologist in Melbourne's western and northern suburbs, assesses and treats bladder stones, including same-anaesthetic HoLEP for men with enlarged prostates. To arrange a consultation, call +61 (03) 9110 3828 or use the contact form.

Bladder Stones — Causes, Symptoms and Treatment in Melbourne