URETHRAL CALCULI

Stone from the bladder is commonly passed out through urethra if it is small, but the stone can get impacted due to a stricture or urethral diverticulum.

Urethral calculi are an uncommon type of urolithiasis, accounting for ~1% of all urinary tract stones.

Urethral calculi are most commonly calcium oxalate (~85%) .

primary: arising de novo secondary to other pathologies such as diverticula, strictures, neurogenic bladder or foreign bodies.

secondary: originate in the upper urinary tract (much more common)

Most impact in the prostatic urethra although ~40% (range 30-50%) are found in the anterior urethra.

SITES OF IMPACTION

• Prostatic urethra
• Bulbous urethra
• Fossa navicularis
• External meatus

CLINICAL FEATURES

• Painful urination with thin stream and forking of urine.
• Retention of urine.
• Lower urinary tract infection.
•  
• Pain in the penis and perineum.
• Stone may be palpable when it is in the bulbar or penile urethra.

INVESTIGATIONS

• Plain X-ray, KUBU (kidney, ureter, bladder urethra).
• Ultrasound abdomen.
• Urine examination.

COMPLICATIONS

• Bleeding
• stricture urethra
• infection

HOMOEOPATHIC MANAGEMENT:

BERBERIS VULGARIS - stitching, cutting pain from left kidney following course of ureter into bladder & urethra. Burning & soreness in region of kidneys.

CANTHARIS- Intolerable urging before, during & after urination. Violent paroxysms of cutting & burning in whole renal region. Violent tenesmus & strangury.

LYCOPODIUM – Pain in back relieved by urinating. Urine slow in coming, must strain. Retension. Polyuria during night. Red sand in urine. Uric acid diathesis. Child cries before urinating. Pains drawing, aching .

SARSAPARILLA - Passage of small calculi or gravel, renal colic, stone in the bladder. Excruciating pains from right kidney downwards. Severe almost unbearable pain at conclusion of urination. Painful distension & tenderness in bladder, urine dribbles while sitting, passes freely when standing.

TABACUM - ureter, left side. With deathly nausea & vomiting. Vomiting violent, with cold sweat, on least motion, with faintness > open air. Nausea incessant as if seasick > in fresh cold air.

OCCIMUM CAN-Renal colic, right sided. Uric acid diathesis. Red sand in urine. High acidity, formation of spike crystals of uric acid. Turbid, thick, purulent, bloody, brick dust red or yellow sediment. Odour of musk. Pain in ureters, cramps in kidneys.

CALCAREA RENAILS -It is a specific remedy for renal stones .

HYDRANGEA 30-It is considered as a stone breaking remedy. Renal calculi, gravel, profuse deposit of white amorphous salts in urine. Renal colic, sharp pain in loins, especially left. Burning in urethra & frequent desire. Urine hard to start. Bloody urine, heavy deposit of mucus. Great thirst with abdominal symptoms & enlarged prostate.