These smooth to slightly rough, relatively large radiopaque stones are often round to angular and usually associated with a Staphylococcus or Proteus urinary tract infection.
General Information
Medical dissolution is most effective for bladder and kidney stones. Urethral stones, especially those causing urethral obstruction are usually removed by other minimally invasive strategies or retrohydropropulsed back into the urinary bladder and removed surgically.
Diagnostic
Urine culture and urinalysis.
Medical
Penicillins (e.g. amoxicillin) are usually effective against infection. Administer antibiotics throughout most, if not the entire dissolution time (i.e. 2 to 3 months). Consider medication to reduce urinary pain, if needed.
X-ray every 5 to 6 weeks. Reduced urolith size/density/number indicates effective therapy, and accurate mineral prediction, and the need to continue dissolution. No change or increased urolith size/density/number is an indication to verify compliance (urine culture, urinalysis) or consider other urolith removal strategies.