Kidney stones after bladder removal: what to know

Bladder removal is usually followed by a urinary diversion, such as a conduit or a reservoir made from bowel. Urine may then drain through a stoma or be emptied in another way. A stone can arise in the kidney, ureter, or the diversion itself; its position and the type of reconstruction affect pain and urine symptoms.

Dehydration, infection, mucus from bowel tissue, urinary stasis and mineral deposits may contribute to stone formation in some people. Flank pain, abdominal pain, painful urination, blood in urine, or difficulty passing urine should be discussed with the urology team because symptoms may not follow the usual bladder pattern.

Contact your urologist or GP for new pain, changes in urine output, blood in the urine or problems with the stoma or reservoir. Assessment may include a urine sample, blood tests and imaging such as an abdominal ultrasound. Bring details of your diversion, previous stones, fluid intake, infections and medicines.

Follow your surgical team’s fluid and catheterisation instructions. Do not flush, irrigate or alter a stoma or reservoir routine unless your care team has taught you to do so. A stone may need monitoring, removal or another procedure depending on its size, location and effect on drainage.

Seek urgent care for severe or escalating flank or abdominal pain, fever or chills, repeated vomiting, a blocked or poorly draining diversion, inability to pass urine as usual, confusion, or feeling suddenly very unwell. A stone that obstructs drainage can be complicated by infection and needs prompt assessment.

Ask: Where could a stone be located in my urinary reconstruction? Is drainage blocked or infection present? Which imaging test is suitable? How much fluid is appropriate for me? Should I change catheter or stoma care, and what symptoms require emergency help?