Bladder stones, an ancient affliction

Stones in the urinary bladder have been a topic written about for all of recorded history. This painful affliction has plagued mankind since antiquity.

The Hippocratic Oath, which forswore a doctor from performing an abortion and is no longer administered in the United States of America since abortions became legal, also contained a proscription to the physician not to “cut for stone” unless specifically trained in the art.

Cutting for stone referred to a technique first developed in ancient times in India of using a sharp blade to cut through the perineum, an area in a man between the anus and the scrotum to reach the bladder and extract a stone or stones. You can just imagine how much a person would have to have suffered to be willing to submit to such a barbaric procedure, which carried a very high mortality rate from hemorrhage and infection and was often followed, if the patient survived, by permanent complications of incontinence.

A bladder stone can lie undetected in the bladder until it causes symptoms. It may obstruct the outflow of urine through the prostate or irritate the bladder wall. The result can be a cascade of painful symptoms with or without bleeding and infection. A small kidney stone can pass through the ureter into the bladder, often with discomfort but sometimes, silently. If the prostate is enlarged, and particularly when the prostate protrudes into the bladder, the stone not infrequently finds itself blocked from exiting the bladder. That is why a small stone, which would ordinarily have passed out of the bladder without difficulty becomes trapped in the bladder where it grows to many times it original size until it is so large, it cannot pass through the outflow pathway of the prostate.

We owe a debt of gratitude to Benjamin Franklin, one of America’s founding fathers, who suffered with bladder stones related to both his prostate obstruction and the gout, a condition, which can cause uric acid stones to form in the kidneys and the bladder. Painful urinary retention often resulted and the practice at the time was to pass a well-lubricated stiff straight hollow reed through the penis into the bladder to drain out the urine. Good old Ben Franklin, invented and constructed a new device, still in use today, called the flexible silk woven catheter. This smooth flexible hollow tube was the forerunner of today’s modern catheters. While not exactly a panacea, it did relieve the excruciating pains of thousands of men, who had been suffering with the agony of bladder stones.

Today uric acid stones can be dissolved by making the urine alkaline with the proper medication. When bladder stones are calcium based rather then made of uric acid, they can be removed by a wide variety of urological procedures, safely performed under anesthesia. However, the underlying prostate problem must also be addressed.

Questions? Call Dr. Okun at 718-241-6767

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