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Physical Characteristics, Qualitative and Quantitative Analysis of Urinary Stones (Pathari)

Suman Parihar, Prasoon Hada and Sneh Sharma

The knowledge of chemical composition of stones (pathari) helps in understanding the mechanism of their formation and thereby providing guidelines for proper medical management of pathari disease. Keeping in view these facts, their weight, physical characteristics, qualitative and quantitative analysis of 58 stones was carried out. Salient features of qualitative analysis were; (a) presence of calcium and oxalate in all stones, (b) presence of ammonium in 96.5% of stones, which indicated either presence of struvite (magnesium ammonium phosphate) or ammonium acid urate and (c) absence of cystine in all the stones. Qualitatively, oxalate was the major constituent of the stone (30.18 + 11.96 g %). Urine chemistry and crystalluria of these stone formers (SF) was also analysed. No relationship was observed between the urine chemistry and chemical analysis of stones. Crystalluria was studied in urine samples from stone formers at the time of admission, just before operation and after seven days of operation. There was decrease in crystalluria in the urine samples after the operation. The weight, shape, colour and surface of the 58 stones removed from different sites of urinary tracts were observed. The largest stone was from bladder weighed 118.5 g. Result showed calcium was present in all the stones. Preponderance of magnesium, ammonium, oxalate and phosphates was also evident in stones from all sites (i.e. kidney, ureter, bladder etc.). Incidence of pure calcium oxalates and calcium phosphate stone was very low .The same was true for the stones having combinations of two constituents (calcium oxalate + calcium phosphate, calcium phosphate + uric acid). Majority of stones had more than three combinations. Ammonium acid urate was present in 86.3 and 97.4% in upper urinary tract and bladder stones, respectively. The quantitative analysis of stone was performed, which revealed that calcium and oxalate was the major constituent of stones irrespective of their sites.