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Urology/bladder stones and suprapubic catheter

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Question
Hello,
I am a 60 year old male. I have suprapubic catheter since two years because my bladder has become very large and I can not empty my bladder fully. My bladder capacity reached Upto 2000l because of enlarged prostrate. After surgery the suprapubic catheter is left which I use to empty my bladder. The supra pubic catheter causes calculus formation. I am taking cran probiotics. I don't know what to do to reduce calculus formation. I do weekly bladder washouts the calculus are still forming. What diet should I take? Should I not eat diet which has oxalate? Please advise me as if the calculus form the only way I have to get them removed is by surgery. I have already removed calculi before and don't want it to firm do quickly. I have read about d manose I don't have it what do you recommend. Is vitamin c, b complex, probiotic helpful?


Many thanks,
YA

Answer
YA:

First, we need to know what the stone is made of.  Most stones in the bladder are composed of calcium phosphate.  If so, then a daily bladder irrigation with 1/4% acetic acid or Renacidin solution should help reduce the risk of more stones.  

A 24 hour urine collection can help identify the chemical promotors of stone formation and help clarify additional preventive treatments.

Without knowing the 24 hour urine chemistry or even the stone composition, it's difficult to recommend any preventive diets or other treatments.

Smaller stones can sometimes be rinsed our, but surgery with either lasers or lithotripsy is often needed for larger stones.

There is some information about D Mannose helping with infections but not with stones.  

There is no solid information about the use of vitamin C, B complex or probiotics except in some specific situations.  You should talk to your physician or urologist about this problem.

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Stephen W. Leslie, MD

Expertise

Questions concerning erectile dysfunction, kidney stones and prostate disorders including prostate cancer. I have a special interest in kidney stone disease prevention.

Experience

Full time practicing urologist with 30 years experience. Associate Professor of Surgery and Chief of Urology at Creighton University Medical Center. Editor in Chief of eMedicine Urology internet textbook. Author of only NIH approved book written for patients by a urologist on the subject of kidney stones "The Kidney Stones Handbook". Inventor of the "Parachute" and "Escape" kidney stone baskets and the "Calculus" stone prevention analysis computer program.

Organizations
American Urological Association, Ohio State Medical Association, Sexual Medicine Society

Publications
Men's Health, Journal of Urology, Urology, Healthwatch Magazine, Emergency Medicine Monthly, eMedicine, "The Kidney Stones Handbook", and numerous articles in various newspapers. He is also the editor of the Urology Board Review by McGraw-Hill used by urologists to study for their Board Certification Examinations.

Education/Credentials
Graduate of New York Medical College with residencies completed at Metropolitan Hospital New York, Albany Medical Center and University of Wisconsin-Madison.

Awards and Honors
Thirlby Award of the American Urological Association. Rated as one the country's Best Urologists by the Independent Consumer's Research Institute

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