Painful Urination

43 y/o patient presented with painful urination, colicky pain in between urination and gross hematuria of 3 days duration. Not currently taking any medications. PMH: intermittent gout. Approach? Not sure what happened.

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Scant shows huge size renal calculus rt kidney and micro lesthiasis in ureter responsible for pain and hematuria
Thanx dr Mrinal Kantil Pal
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SUGGESTIVE of NEPHRO URETERO LITHIASIS.. ..
Stone in the right kidney
Stone rt kidney in the middle calyx Pt having haematuria with painful micturation means stone is trying to move. Automatic passage of the stone is best way to get rid of it . For that size and site and side of the stone has got role . NECT gives you the best idea to determine the size site . Size upto 6. 5 mm automatic passage is about 9% . Above that size is very difficult. Force diuresis may the passge slight easier. Above all after getting all investigation treating physician is the best judge to decide.
Rensl colic following obstructive uropathology. DD.Acute Cystitis. If size is more than 9 mm...it is advised to undergo Lithotripsy...shock wave.
Renal and ureteric stones Need PCNL and ureteroscopy
Bilateral nephro uretero lithiasis
Uric acid renal stone.

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