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Bladder stone
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==Management== Increasing fluid intake can facilitate the passage of small bladder stones. However, larger stones may require other methods of treatment.<ref name=BladderStones>[http://health.nytimes.com/health/guides/disease/bladder-stones/overview.html Bladder Stones: NY Times Health Information], Retrieved on 2010-01-19.</ref> Fragmentation of bladder stones can be achieved by use of a [[Cystoscopy|cystoscope]] which is inserted into the bladder. The [[urology|urologist]] visualizes the stone and uses [[ultrasound|ultrasonic energy]] or [[laser lithotripsy]] to cause fragmentation of the stones into small pieces, which are then flushed out of the bladder. This procedure requires [[anesthesia]] and may require admission to a hospital. Complications of this treatment include infection and damage to the bladder.<ref name="Bladder Stones Overview: University of Maryland Medical Center">[http://www.umm.edu/ency/article/001275.htm Bladder Stones Overview: University of Maryland Medical Center], Retrieved on 2010-01-19.</ref> Some stones are too large even for cystoscopic treatment and may require open cystotomy, in which an incision is made in the bladder and the stones are removed manually. For children with urinary stones, the evidence supporting treatment options is very weak and high quality trials are necessary to help guide clinical management.<ref>{{Cite journal|last1=Barreto|first1=Lenka|last2=Jung|first2=Jae Hung|last3=Abdelrahim|first3=Ameera|last4=Ahmed|first4=Munir|last5=Dawkins|first5=Guy P. C.|last6=Kazmierski|first6=Marcin|date=2019-10-09|title=Medical and surgical interventions for the treatment of urinary stones in children|journal=The Cochrane Database of Systematic Reviews|volume=2019|issue=10|pages=CD010784|doi=10.1002/14651858.CD010784.pub3|issn=1469-493X|pmc=6785002|pmid=31596944}}</ref> ===Cystolithotomy=== Cystolithotomy is a surgical procedure for the removal of bladder stones in the case that one has been deemed too large to pass naturally, such as developed jackstone calculi. This may require open surgery to remove the stone, however robotic cystolithotomy allows for a minimally invasive approach to remove the stone through much smaller incisions than the traditional approach. Most bladder stones can be dealt with by an endoscopic procedure, to avoid the need for a surgical incision. An open cystolithotomy is performed under [[general anesthesia]] as an [[inpatient]] procedure. The first step is a [[cystoscopy]] to examine the bladder, then an incision is made in the lower abdomen. Once the stone is removed, the bladder is repaired with an absorbable stitch, and a [[catheter]] is inserted into the bladder via the [[urethra]]. Occasionally it is necessary to gently drip fluid in and out of the bladder for a period, as there is often some bleeding following the procedure. The majority of patients do not have major side effects following cystolithotomy, but it may be followed by a minor burning sensation and light bleeding. More serious side effects include bladder infection, a prolonged need of catheter use, and infection in the surgical incision. Rare side effects may include delayed bleeding requiring removal of clots or further surgery, injury to the urethra causing [[scar]] formation, fever and more serious infection requiring a longer hospital stay, and delayed healing of the bladder, which may require a further procedure.<ref>{{cite web|url=http://www.nickbrookurology.com/cystolithotomy-open-removal-of-bladder-stones|title=Cystolithotomy (Open Removal of Bladder Stones)|website=Nicholas Brook Urology|publisher= Nick Brook Urologist Adelaide|year=2013|access-date=17 April 2014}}</ref>
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