Post Date December, 03 2023
Urinary calculus is the general name of calculus diseases in various parts of the urinary system, and is a common disease of the urinary system. According to the location of the stones, they can be divided into kidney stones, ureteral stones, bladder stones and urethral stones. The formation of this disease is closely related to environmental factors, systemic diseases and urinary system diseases. Its typical clinical manifestations include abdominal colic, hematuria, or symptoms of urinary system obstruction and infection such as frequent urination, urgency and pain in urination.
What are the symptoms of urethral calculus?
Urethral calculus can also be divided into primary and secondary types. Primary urethral calculus is rare. Clinically, most of the stones that occur in the urethra come from the urinary system, especially the bladder, and can also occur in the urethral diverticulum. In male patients, the stones were mainly embedded in the urethra of the prostate, the navicular fossa of the urethra or the external urethral orifice. Urinary line of patients with urethral calculi is very thin when urinating, even urinary retention occurs. Moreover, the site of stone incarceration is painful, accompanied by lower urinary tract infection. The stone in the anterior urethra can often be touched by palpation. Some patients even see stones through the urethral orifice. The stones secondary to the urethral diverticulum may not have any discomfort and urine flow changes during urination, but there is secretion at the urethral orifice, and stones can also be touched.
What to do with urethral calculus
Treatment I
If the stones close to the external orifice of the urethra and the small stones located in the navicular fossa cannot be discharged by themselves, they can be injected with liquid paraffin and then squeezed out, or can be removed with forceps or tweezers. After injecting liquid paraffin into the anterior urethral calculus, the calculus can be pushed to the external orifice of the urethra by hand, and then the calculus can be clamped out with pliers or tweezers. You can also pull out the probe or bend the probe into a hook to hook out the stone. But the operation must be gentle to avoid serious injury to the urethra. For larger urethral stones or those embedded in the navicular fossa, if the above methods cannot work, the external orifice of the urethra can be cut, sterile liquid paraffin can be poured into the urethra, and then the stones can be removed by squeezing and clamping.
Treatment II
Anterior urethrotomy lithotomy can be performed for those who have severe incarceration of urethral stones before the operation and cannot be removed through the urethral orifice. There is a possibility of forming urinary fistula after urethrotomy of penis, so the method of urethrotomy and lithotomy should be avoided as far as possible. At this time, the stone can be pushed to the bulbous urethra, and the stone can be cut at the bulbous urethra as far as possible.
Treatment III
Treatment of posterior urethral calculi For posterior urethral calculi, the urethral probe can be used to push the stones back into the bladder, and then the powerful forceps lithotripsy, pneumatic ballistic lithotripsy, laser lithotripsy and other methods can be used under the endoscope, or extracorporeal shock wave lithotripsy or suprapubic cystotomy can be used to remove stones. If the stone is large and incarcerated, the stone can be removed through the perineum or suprapubic incision. The stones in the urethral diverticulum must be removed at the same time. Patients with urethral obstruction and infection need to be treated together.
Treatment IV
Urethroscopic lithotomy If urethral stricture hinders the discharge of stones or the stones are severely embedded, the stricture section can be cut through the urethroscope under the endoscope before lithotomy. If the stone is large and has been embedded in the urethra for a long time, it can be treated with pneumatic ballistic lithotripsy or laser lithotripsy under endoscope. If the stone cannot be removed, it can be removed by urethrotomy.
