Bladder (vesical) calculi are stones or calcified materials that are present in the bladder (or in a bladder substitute that functions as a urinary reservoir). They are usually associated with urinary stasis but can form in healthy individuals without evidence of anatomic defects, strictures, infections, or foreign bodies. The presence of upper urinary tract calculi is not necessarily a predisposition to the formation of bladder stones.

Bladder calculi are an uncommon cause of illness in most Western countries, but they result in specific symptoms and are a significant source of discomfort. This article discusses the diagnosis and current management techniques for vesical calculus disease.

The incidence of bladder stones in children is slowly declining, even in endemic areas. This is mostly due to improved nutrition, better prenatal and postnatal care, and improved awareness of the problem in the endemic areas. In the 21st century, the incidence of this disease in children will probably continue to decline, and the disease will largely become a disease of adults.

Aggressive treatment of lower urinary tract symptoms with alpha-blockers and 5-alpha-reductase inhibitors should further decrease the overall incidence of bladder stones by improving bladder emptying. Removal of bladder stones will continue to progress toward minimally invasive techniques, thus decreasing hospital stay and recovery times. Continued advances in surgical equipment and the ability to downsize without the sacrifice of effectiveness could eventually render open surgery for stones obsolete.

In addition, continued aggressive management of neurogenic bladder, specifically in the pediatric neurogenic bladder population, may lead to a rise in both the incidence of struvite stones and the development of creative and minimally invasive surgical techniques for augmented bladders.