Urethral calculi

Most of the calculi come from the kidney and bladder, except for a few originating from urethral diverticula or urethral stricture. Male urethral calculi are prone to become embedded in the prostate urethra,舟状窝urethra and urethral orifice.

　　The general complications of urethral calculi are as follows:

　　6. Cause local injury: Small calculi can move freely in the urethra, easily abrade the urethral mucosa, causing bleeding, renal colic, while large, relatively fixed or horn-like urethral calculi will compress the urethral mucosa for a long time, causing epithelial shedding, tissue ulceration, and even leading to adhesion between calculi and ureteral closure, which may lead to cancer in severe cases.

　　5. Cause infection: Calculi can cause urinary tract obstruction, and urine cannot be completely excreted from the body, providing a favorable environment for bacterial growth, which is easy to cause urethral infection.

　　4. Lead to urethral obstruction: Renal and ureteral calculi are most prone to stay at the renal pelvis ureteral junction, causing urethral obstruction.

　　4. Lead to renal function damage: Calculi cause obstruction, especially long-term obstruction of ureteral calculi can lead to hydronephrosis, thereby affecting renal function, but once the calculi are removed, renal function can be restored.

⒈ Urinary pain.
⒉ Difficulty in urination.
⒊ Urinary retention.
⒋ Hematuria and frequent urination, urgency.
⒌ Urethral ulcer, urine extravasation.
⒍ Physical examination can touch the stones, and anal examination can touch the posterior urethral stones.
⒎ Urinary probe can touch the stones.

　　Drinking water, exercise, and a reasonable diet are of great significance for the prevention and treatment of urinary tract stones.

　　Drinking less water and less urine are common characteristics of patients with urinary tract stones. Excessive sweating and concentrated urine are important factors in the formation of stones. Therefore, drinking more water can dilute the concentration of urine, increase the amount of urine excreted, and make it difficult for the components in the urine to precipitate, and can also play a flushing role in the urinary tract. It is reported that people who have less than 2 catties of urine per day have a higher incidence of stones, while those who have more than 4 catties of urine per day have a lower incidence. This shows that drinking more water every day can prevent the occurrence of urinary stones.

　　Next is exercise. Exercise can strengthen the physique and enhance the body's resistance to diseases. Exercise not only makes it difficult for urinary tract stones to form, but also helps to accelerate the excretion of small sandstones with urine. A study by Filipino doctors found that most stones less than 5 millimeters in the urinary tract can be excreted spontaneously, provided that they drink more water and exercise more.

　　In addition, eating less meat, more vegetables, more coarse grains, and paying attention to the intake of vitamin A will play an important role in preventing urinary tract stones and will also be beneficial in combination with treatment.

1. Urinalysis can show red blood cells, white blood cells, and salt crystals. There may be pyuria if there is infection.
2. X-ray examination X-ray film can confirm the presence and location of urinary tract stones, and can also check for stones in the upper urinary tract at the same time. Urethrogram can detect negative stones, whether there is urethral stricture and diverticulum.
3. Ultrasound The ultrasound image of urinary tract stones shows strong echo spots in the urethral lumen, accompanied by shadowing.
4. Ureteroscopy Ureteroscopy can directly observe stones, complications of the urethra, and other abnormal conditions.

　　There is a close relationship between urinary tract stones and diet. If patients do not eat properly, it will worsen the condition of the stones. The following are some dietary precautions for patients with urinary tract stones:

　　1. Don't drink milk before going to bed. Because milk contains a lot of calcium, and most urinary tract stones contain calcium salts. The most dangerous factor in the formation of urinary tract stones is the sudden increase in the concentration of calcium in urine for a short period of time. Two to three hours after drinking milk is the peak time for calcium to be excreted by the kidneys. If you are in a state of sleep at this time, the urine will be concentrated, and more calcium will pass through the kidneys, so it is easy to form stones.

　　2. Eat less animal内脏. Control the intake of meat and animal organs, because meat metabolism produces uric acid, and animal organs are high-purine foods, which also produce high blood uric acid during metabolism. Uric acid is a component of urinary tract stones. Therefore, daily diet should be vegetarian, and foods rich in fiber should be eaten more.

　　3. Drink less beer. Some people believe that beer can diuretic and prevent the occurrence of urinary tract stones. In fact, the malt juice in beer contains acidic substances such as calcium, oxalic acid, uridine and purine nucleotides, which can increase uric acid in the human body, becoming an important cause of kidney stones.

　　4. Eat less salt. Too much salt in the diet will increase the workload of the kidneys, and salt and calcium have a synergistic effect in the body, which can interfere with the metabolism of drugs for the prevention and treatment of kidney stones. The daily intake of salt should be less than 5 grams.

　　5. Eat dinner early. The peak period for calcium excretion in humans often occurs 4 to 5 hours after a meal. If dinner is late, when the peak period of calcium excretion arrives, people have already gone to bed and fallen asleep, and urine accumulates in the urinary tract, such as the ureters, bladder, and urethra, and cannot be excreted in time from the body. This causes the calcium in the urine to increase continuously, which is easy to precipitate and form small crystals. Over time, these crystals gradually expand to form calculi.

　　6. Eat more vegetables and fruits. Vegetables and fruits contain vitamin B1 and vitamin C, and their final metabolic products in the body are alkaline. Uric acid is easily dissolved in alkaline urine, so it is beneficial for the treatment and prevention of urinary calculi.

　　7. Drink plenty of water and do not hold urine. Do not hold urine, drinking and urinating more can help bacteria, carcinogens, and substances prone to forming stones be quickly excreted from the body, reducing the chance of kidney and bladder damage.

　　Small calculi near the urethral orifice can be tried to extrude by injecting a large amount of paraffin oil, or they can be removed with tweezers or forceps, or the front end of the probe can be bent into a hook shape to try to hook out the calculi. However, it is not advisable to repeatedly try to squeeze out large calculi, as this may cause widespread damage to the urethral mucosa.

　　The calculi embedded in the orifice of the urinary tract or the vesical fossa may sometimes require the incision of the urethral orifice to remove the calculi.

　　The calculi in the posterior urethra can be pushed back into the bladder with a urethral probe, and then crushed with a urethral lithotripsy forceps or removed by suprapubic cystolithotomy.

　　If there are calculi in the urethral diverticulum, the diverticulum and the calculi should be removed together.

　　If the calculi are tightly embedded in the anterior urethra and cannot be removed or pushed back into the bladder, a straight incision should be made on the side of the penis, the incision should be pulled towards the center, the urethra should be incised to remove the calculi, and the incisions should be sutured in layers with catgut to prevent the formation of postoperative urinary fistula.

　　Occasionally, there are dumbbell-shaped large calculi in the urethra and bladder, which require the bladder to be incised and the calculi to be slowly loosened and completely removed. Due to the long-term embedding of the calculi in the posterior urethra, urinary incontinence may occur after the calculi are removed.