URETHRAL CALCULI

Urethral Calculi

Definition

Urethral calculi are small, hard masses that form in the urethra due to the accumulation of minerals and salts.

Types

1. Struvite stones: These are the most common type of urethral stone and are formed from the minerals magnesium, ammonia, and phosphate.
2. Calcium oxalate stones: These stones are formed from the mineral calcium oxalate and are less common than struvite stones.
3. Cystine stones: These stones are formed from the mineral cystine and are rare.

Clinical Features

1. Painful urination: Patients with urethral calculi may experience painful urination or dysuria.
2. Difficulty starting urination: Patients may have difficulty starting urination or may need to strain to urinate.
3. Urethral bleeding: Patients may experience urethral bleeding or hematuria.
4. Urethral discharge: Patients may have a foul-smelling discharge from the urethra.

Investigations

1. Urinalysis: A urinalysis may show the presence of blood, bacteria, or minerals.
2. Imaging studies: Imaging studies such as X-rays, CT scans, or ultrasound may be used to visualize the stone and rule out other conditions.

Complications

1. Urethral stricture: Urethral calculi can cause urethral stricture, which is a narrowing of the urethra.
2. Chronic kidney disease: Untreated urethral calculi can lead to chronic kidney disease.
3. Urosepsis: Urethral calculi can cause urosepsis, which is a life-threatening infection.

Management

1. Conservative treatment: Conservative treatment may include pain management, antibiotics, and urethral catheterization.
2. Surgical treatment: Surgical treatment may include urethrotomy, urethral dilation, or urethral stenting.
3. Endoscopic treatment: Endoscopic treatment may include laser lithotripsy or ureteroscopy.

Treatment

1. Urethrotomy: Urethrotomy involves making a small incision in the urethra to remove the stone.
2. Urethral dilation: Urethral dilation involves using instruments to widen the urethra and remove the stone.
3. Urethral stenting: Urethral stenting involves placing a stent in the urethra to keep it open and allow the stone to pass.

Blood Supply

1. Internal iliac artery: The internal iliac artery supplies blood to the urethra.
2. Common penile artery: The common penile artery also supplies blood to the urethra.

Nerve Supply

1. Pelvic nerve: The pelvic nerve supplies nerve fibers to the urethra.
2. Pudendal nerve: The pudendal nerve also supplies nerve fibers to the urethra.

Clinical Anatomy

1. Urethral sphincter: The urethral sphincter is a muscle that surrounds the urethra and helps to control urination.
2. Urethral crest: The urethral crest is a ridge of tissue in the urethra that helps to guide the flow of urine.
3. Prostatic utricle: The prostatic utricle is a small cavity in the prostate gland that connects to the urethra.

Homoeopathic Therapeutic Medicines

1. Apis: Apis is used to treat urethral bleeding and painful urination.
2. Cantharis: Cantharis is used to treat painful urination and burning sensations in the urethra.
3. Nux vomica: Nux vomica is used to treat urethral stricture and difficulty starting urination.

MUHS-Relevant Points

1. Urethral calculi are a common cause of urethral obstruction: Urethral calculi can cause urethral obstruction, which can lead to chronic kidney disease.
2. Endoscopic treatment is the preferred treatment for urethral calculi: Endoscopic treatment is the preferred treatment for urethral calculi because it is minimally invasive and has a low risk of complications.
3. Urethral calculi can cause urethral stricture: Urethral calculi can cause urethral stricture, which is a narrowing of the urethra.