Dr. Movahid Anwer (one of the most adventurous and self-starting PGRs of ward-5) removed 80 stones lodged in the urethra of a 55 years old male patient who came with urinary retention in the accident and emergency department. He was complaining of severe lower abdominal and penile pain. On examination, the patient had a lot of stones deposited throughout his urethra. Dr. Movahid Anwer (PGR) and Dr. Muzammil Irshad (H/S) got laid down the patient on the bed and tried to remove the stones using lignocaine gel and artery forceps. Dr. Tauqeer Ahmad (notorious punster H/S of ward-5) helped a lot during all this conquest. Dr. Nadeem PGR (cool gagster) and Dr. Khalid Javed PGR (decent humorist) apprised the case with their eloquent knowledge of conduct.
It made the doctors mouths gap opened when they found large sized stones pegged throughout the urethra. The patient passed urine when the 80th stone was being removed. It was all the effort of Dr. Movahid and Dr. Muzammil Irshad who made the patient to get rid of his urethral stones.
Actually, the patient had been taking homeopathic medicines for kidney stones for the last 3 months. These were the kidney stones which had reached the urethra passing through the ureters and urinary bladder, and caused urinary retention. On the removal of urethral stones, the patient was passed urinary catheter (Folley’s catheter) in order to avoid urethral stricture.
Urinary retention is one of the most common causalities seen in surgical department. Urinary retention can be acute, chronic and retention with overflow. Urinary retention differs in male, female, infants and children. Chronic retention can be caused by BPH, bladder neck
contracture, urethral stricture and stones. BPH and prostate cancer occur in old age. Trauma to pelvis may lead to urethral strictures. Similarly, perineal surgeries such as haemorrhoidectomy, fistulectomy, fissurectomy, pelvic surgeries and surgeries for hip fracture or pelvic bone can also cause urinary retention. Moreover, spinal injuries and certain drugs (anticholinergic, antihistamines, and antidepressants) also contribute to urinary retention.
Usually, the patient with chronic urinary retention presents pain and swelling in the supra-pubic region. The patient is unable to urinate or just dribbles. Smooth, soft, tender swelling in hypogastrium
can be palpated which on percussion manifests dullness of the area. Urinary retention can be relieved by catheterization or supra-pubic cystostomy. But, it is more important to deal with the cause of urinary retention.
Can you imagine eighty stones in in such a small urethra? Can these be removed within half an hour? Yes it happened to occur that patient came with stones in his urethra and were removed by the genius doctors!
Dr. Muzammil Irshad (firstname.lastname@example.org)
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