How does urolithiasis occur? Urolithiasis in women: symptoms and treatment, folk remedies

The kidneys cleanse our body of various harmful and unnecessary products around the clock. Every 7-8 minutes, each person's blood completely passes and is filtered through them. Unfortunately, in the functioning of the kidneys, as well as any other organs, problems can occur. serious violations due to the formation of stones in the urinary tract. This disease is called urolithiasis. What causes and develops this disease? In this article, the editors of the website www.site and I will talk about the causes of urolithiasis and its development.

The formation of stones occurs not only due to diseases of internal organs, but also from certain environmental factors.

Gradual layers of salts around any particle, for example, a microorganism, lead to the appearance of stones in the ureters and kidneys. Being in one place for a long time and thereby blocking the outflow of urine, stones make changes to the urinary tract. This may be a local expansion of the ureter or kidney, as well as a disruption in the nutrition of their tissues, which usually leads to a gradual loss of organ function.

Causes of the appearance and development of urolithiasis

There are external and internal factors that contribute to the emergence and further development ICD.

The main internal factor includes violation metabolic processes V human body– fat, mineral or protein metabolism, which results in the formation of excess substances that precipitate. Metabolic processes can be both a consequence of diseases and an independent condition.

Impaired outflow of urine from the kidneys through the ureters bladder and further from it into the urethra is an important factor in the development of urolithiasis. With such a violation, a reverse flow of urine against the current or its stagnation in the bladder or kidneys may occur, which leads to the accumulation salt deposits.

The flow of urine may be impaired as a result birth defects development of the urinary organs, various inflammatory diseases, and traumatic injuries. For example, narrowing of the ureter, nephritis, kidney prolapse, cystitis, etc.

Various diseases of the gastrointestinal tract, musculoskeletal system, liver and other organs can also cause the development of urolithiasis.

Disturbances in the functioning of the adrenal glands and thyroid gland are internal factors that contribute to the formation of stones in the urinary tract.

External factors influencing the development of urolithiasis:

Excessive content in food table salt;

Lack of fluid;

Abuse of various spices containing salt;

Consumption of large amounts of smoked foods and alcoholic beverages;

Self-administration of medications such as aspirin, antibiotics, hormonal drugs, agents that help reduce the acidity of gastrointestinal juice;

Chronic pyelonephritis.

The latter reason contributes to the formation of salt deposits in the kidneys and urinary tract in 30-35% of cases. Moreover, urolithiasis caused by chronic pyelonephritis is very difficult and can reappear even after treatment and removal of the stones.

Stones can vary in composition and can be phosphate, urate, carbonate and oxalate. Several stones can form in the renal pelvis at the same time. During interictal period Urolithiasis can occur without any special symptoms; the patient, as a rule, has no complaints.

But over time, with development renal colic attacks of ICD begin to appear. Renal colic can be triggered by heavy physical activity, alcohol abuse, and drinking large amounts of liquid. It can manifest itself in the form of sharp, paroxysmal pain in the lumbar region. This painful attack is associated with the movement of stones through the ureters. After the stone passes, the attack stops. In addition to pain, there is often increased arterial pressure, body temperature, nausea and vomiting appear, and the amount of urine excreted decreases.

Currently urolithiasis Diagnosed using ultrasound examination of the kidneys, radiography, as well as a general urine test.

As first aid, you can use a hot heating pad, which must be applied to the lumbar area, and if there are no contraindications, you can take hot bath. In addition, experts recommend painkillers in tablets and antispasmodics (for example, no-spa). If these methods have no effect, then it is necessary to urgently call an ambulance.

How to cope with urolithiasis at home

Urolithiasis can be considered a leader among kidney pathologies. The disease begins with the formation of microliths, that is, “sand” in the kidneys, from which stones then form. If the stone is large in size, when moved it can block the ureter, the outflow of new urine will occur in the kidney, and the body will not be cleansed. The result is often hydronephrosis, a severe urolithiasis. In order to avoid such consequences, it is important to know about the basic principles and methods of treating urolithiasis, which you can do yourself at home.

Briefly about the ICD

Statistics show that the risk of developing kidney stones for men is three times higher than for women. However, big coral stones more often they form among representatives of the fair half. A cluster of stones is often found in one kidney, but every seventh or tenth patient can be diagnosed with bilateral KSD. In some cases, the disease affects the ureters and bladder in addition to the kidneys.

Types of stones for urolithiasis

Calcium phosphate stones are white or light gray stones with a smooth or slightly rough surface, and are quite soft in consistency. This type of stones forms if there is a lot of phosphorus and calcium in the urine.

When there are a lot of oxalic acid salts or oxalates in the urine, calcium oxalate stones appear, quite dense, with spine-like growths on the surface. Stone color – gray-black

Urate stones can be distinguished by their yellow brick-tinged color, smooth surface and hardness. It is important in the event of the formation of such stones to normalize the amount uric acid.

If we talk about cystine stones, their difference is their white-yellow hue, hardness, and roundness. Stones appear due to impaired circulation of the amino acid cystine.

Sometimes stones can consist of magnesium, ammonium, calcium, and phosphates. The reason for their development in the body is bacteria that have penetrated the genitourinary tract and produce urease there, that is, an enzyme that breaks urine into ammonia and carbon dioxide. Such stones are similar in appearance to rectangular prisms and can grow to large sizes, turning into coral-shaped stones.

You can name several more types of stones. For example, calcium carbonate, which is distinguished by its white color, smoothness and softness. Protein stones of the urinary system are also soft and white in color. Soft, but black in color - cholesterol stones.

The acidity of urine and its pH affects the type of stones. Simply put, stones can form in an acidic or alkaline environment, that is, they differ in characteristics. The most common are oxalates, urates, and phosphates. As soon as it is possible to determine the type of stones and their composition, the specialist determines what the treatment will be.

General rules of treatment

Drink more. This will help prevent urine from accumulating in the body, which means that existing stones will not increase in size or new ones will form. If you have nephrolithiasis, you need to drink several liters of water per day. When it comes to diet, you should focus on the pH of the salts accumulated in the body. The purpose of the diet is to dissolve small stones.

Move more. Thanks to physical activity, you will help the body get rid of everything unnecessary and cope with the “stagnation” of harmful substances.

Experts also include stone removal using surgical and conservative methods as general principles of treatment. Their appointment, of course, takes place individually.

Features of treatment for different types of stones

It is worth limiting cocoa-containing products if you have calcium oxalate stones. Avoid coffee with tea, spinach, sorrel, leaf lettuce, strawberries, nuts, citrus fruits, cheese, legumes, fermented milk products. It is better not to eat during treatment black currant. Mineral waters of low mineralization (for example, Naftusya) are suitable.

Reducing the amount of protein in the menu, as well as chocolate, alcohol, coffee and cocoa, offal, fried and spicy foods, and meat broths will help cope with urate stones. Among mineral waters, alkaline waters are especially useful (for example, Slavyanovskaya, Essentuki No. 17.4, Borjomi).

It is recommended to enrich the diet with meat, apples, pears, sauerkraut, grapes, kefir and mineral waters that oxidize urine (Narzan dolomite, Naftusya, etc.) if there are phosphates in the kidneys. At the same time, do not consume milk, spicy snacks, spices, potatoes, legumes, pumpkin, green vegetables, or cottage cheese for some time.

Methods for preventing urolithiasis

To help your kidneys and not provoke the development of urolithiasis, eat less chocolate, fatty foods and hot spices. Pay more attention to drinking plain water (up to 1.5 liters per day), and less to cocoa, coffee, strong drinks and teas. Normalize your body weight, monitor the amount of calories and salt your body receives. Let drinking herbal teas and decoctions become a healthy habit.

Urolithiasis disease(ICD) is a pathology that is always accompanied by pain. Discomfort is often localized in the lower back. But if you go to the exit, pain can be felt throughout the entire abdominal area. Such symptoms often underlie incorrect diagnosis and make one suspect the patient has appendicitis or an ulcer. Therefore, let’s look at the symptoms and treatment for men diagnosed with urolithiasis.

What is the basis of the disease?

The disease is much more common among the stronger sex than among women. Statistics provide the following figures. Men are three times more likely to be diagnosed with urolithiasis.

Doctors divide the causes of pathology into two groups: external and internal factors. Let's look at them.

External factors leading to the formation of stones:

Features of the climate. Dry air often leads to dehydration.
Soil structure. It affects the electrolyte content of products.
Water. In case of urolithiasis, the source of pathology can be excess salts in the fluid consumed. This leads to a high concentration of them in the urine. In addition, the acidity of the water affects stone formation.
Daily regime. Physical inactivity contributes to the development of pathology.
Lack of fluid. A small amount of water consumed seriously increases the risk of disease.
Diet. Excessive consumption contributes to the formation of stones. meat products, as well as food containing many purine bases (sorrel, spinach, peas).

These are not the only sources that influence the development of such pathologies as urolithiasis. The reasons may lie in internal factors:

Infectious diseases of the urinary tract: urethritis, cystitis, pyelonephritis, prostatitis.
Pathologies digestive tract: pancreatitis, hepatitis, colitis.
Infections of other organs: osteomyelitis, furunculosis, tonsillitis.
Abnormal development of the bladder, kidneys, and ureters.

Symptoms of the disease

No special clinical manifestations on initial stages does not have urolithiasis. Symptoms and treatment in men are often absent during this period. Pathology may be discovered if other diseases are diagnosed.

Characteristic signs of urolithiasis occur in the patient when stones advance. The most basic symptom is severe, sudden onset pain. This condition is characterized as renal colic.

It is characterized by the following symptoms:

Paroxysmal severe pain that periodically worsens.
A rise in temperature may occur.
Painful discomfort appears suddenly, often during shaking, movement, or after drinking a large amount of liquid or alcohol. Changing body position does not eliminate pain.
Discomfort can spread to the lumbar region, lower abdomen, and groin.

Features of symptoms

The localization of pain and its nature make it possible to determine the place where the stones are located if the patient is diagnosed with urolithiasis. Symptoms and treatment in men depend entirely on their location:

Discomfort that occurs in the lumbar region (in the region of the costovertebral angle), spreading to the groin, characterizes the localization of kidney stones and their movement along the ureter. With this pathology, blood often appears in the urine.
If the pain is concentrated on the side of the lumbar area and spreads to the groin, then the stone is located high. Painful discomfort occurs as a result of stretching of the kidney capsule.
A moving stone always causes painful sensations. The pain usually radiates to the anterior thigh and scrotum.
The pain is constant. Sometimes the patient experiences periods of relief, which are followed by exacerbation. Such symptoms are typical for localization

In addition to the above clinical manifestations, other signs may be observed:

dysuria;
deterioration of the patient's condition;
elevated temperature;
hematuria;
nausea, vomiting;
delayed urine output due to blockage of the bladder neck.

Diagnosis of the disease

To confirm the diagnosis of urolithiasis, the attending physician examines the patient very carefully. The doctor is interested in the treatment carried out in the past, its effectiveness. Such measures make it possible to correctly prescribe adequate therapy.

The diagnosis is made based on the following data:

The patient has characteristic symptoms. Periodically appearing sharp pains in lumbar region, stomach or groin. Incomplete emptying of the bladder. A burning sensation in the urethra during urination.
Inspection data. The doctor palpates the abdomen, as a result of which inflammatory pathologies of the peritoneum, such as pancreatitis, cholecystitis, and appendicitis, are excluded. Tapping lumbar area and abdomen makes it possible to differentiate pathology from lumbago, radiculitis, pyelonephritis. An external examination of the patient can characterize many factors. The patient’s posture, skin color, and the presence of swelling are taken into account.
Indicators of general urinalysis characteristic of pathology. As a rule, increased density is detected. Unchanged red blood cells are found in the urine. A high concentration of salts is noted. Such indicators of a general urine test indicate the presence of urolithiasis in a patient.
Ultrasound data. This examination With high accuracy determines the diagnosis and gives an idea of the size, shape and location of stones.
CT results. The examination is used if ultrasound does not provide a complete description of the pathology.
Results of X-ray contrast examination. This method allows you to examine the urine flow in detail. Diagnostics reveals where the blockage of the ducts occurred.

Types of stones

It is very important not only to identify such a pathology as urolithiasis. Symptoms and treatment in men depend entirely on the type of stone. That is why it is advisable not to resort to traditional medicine, but to entrust your health to an experienced professional.

The following stones can form due to urolithiasis:

Oxalate. Such stones are formed from calcium salt. They are distinguished by their high density and prickly surface. Initially their color is black and gray. If a stone injures the mucous membrane, it becomes black or dark brown due to the blood pigment.
Phosphate. They contain calcium salt of phosphoric acid. Typically, the stone is smooth or slightly rough. It can take on a variety of shapes. The consistency of the stone is soft. It is distinguished by its light gray or white color. This type of stone tends to rapid growth. Very easy to crush.
Urate. They are formed either by its salts. The stones are yellow-brick in color. They have a smooth surface but a hard consistency. Crushing is possible with the help of medications.
Carbonate. They contain calcium carbonate. The consistency of the stones is soft, and the shape is varied. The calculus has a smooth surface and is white in color.
Cystine. They are formed by the sulfur compound of the amino acid cystine. Stones round shape, yellowish-white. As a rule, they have a smooth surface and soft consistency.
Protein. Their formation is promoted by fibrin mixed with bacteria and salts. Stones white, small, soft and flat.
Cholesterol. They are extremely rare in the kidneys. They consist of cholesterol, have a soft consistency, and are black in color. Such stones are dangerous because they crumble easily.

Treatment of the disease

The tactics to combat pathology are determined by the urologist. For treatment, surgical methods and conservative therapy are used. Choice required method depends on the patient’s condition, his age, the size and location of the stone, the clinical course of the pathology, the presence of physiological or anatomical changes, as well as stages of renal failure.

In most cases, surgical treatment must be used to remove stones. The exception is stones formed by uric acid. These stones can be dissolved with conservative treatment.

Initially, the patient is prescribed the following medications for urolithiasis:

Antispasmodics. They eliminate spasm of the ureter and help relax its walls. This reduces pain and facilitates the passage of stones. The following drugs are recommended to the patient: “Papaverine”, “No-shpa”, “Halidor”, “Diprofen”.
Painkillers. They are prescribed in case of an attack of renal colic. Medicines that perfectly eliminate pain: “Analgin”, “Bral”, “Tempalgin”, “Baralgin”, “Pentalgin”, “Tetralgin”.

Some patients may be prescribed antibacterial drugs. They are introduced into therapy if an infection is associated with urolithiasis. The choice of necessary antibiotics can only be made by a doctor based on an examination.

Dissolution of urates

It is extremely important to understand: only a doctor will tell you how to treat urolithiasis, since you can choose the necessary medications to dissolve the stone after determining its type.

The following drugs are used to treat urate:

“Allopurinol”, “Allozyme”, “Allopron”, “Allupol”, “Zilorik”, “Milurit”, “Remid”, “Sanfipurol”, “Purinol”. Such medications help reduce the deposition of uric acid salts.
"Etamide". The medicine stimulates intensive excretion of urates along with urine. Helps reduce uric acid salts in the body.
"Ugly." A combined drug that causes alkalinization of urine. The medicine promotes the formation of soluble salts with uric acid.
"Uralit U". The product is used to dissolve urates. Protects the body from the formation of new stones.
"Blemaren." The drug is capable of dissolving urates and some other urinary stones.
"Solimok." Excellent dissolves urinary stones, mainly urates.

Oxalate dissolution

If a patient is diagnosed with these stones, drug therapy includes medications:

"Marelin."
"Spilled." Herbal preparation, which promotes the dissolution of oxalate stones.
Medicinal fees No. 7; No. 8; No. 9; No. 10. Such remedies are officially recognized by urology. They have diuretic, litholytic (stone-dissolving) and antispasmodic properties.

Phosphate dissolution

To combat this pathology, the most popular drugs are:

"Madder extract." This product allows you to loosen phosphates. In addition, the medicine has antispasmodic and diuretic effects.
"Marelin." The drug not only softens stones, but also perfectly eliminates spasm of the renal pelvis and ureter. The medicine relieves inflammation in the genitourinary system.

Dissolution of cystine stones

If this pathology is detected, it is most advisable to take the following medications:

"Penicillamine." The product forms a certain compound with cystine that easily dissolves in urine. This helps reduce stones.
"Tiopronin." The effect on the body of the drug is similar to the above-mentioned medicine. It is prescribed if Penicillamine is ineffective.
"Potassium citrate", "Sodium bicarbonate". Medicines that alkalinize urine. As a result, cystine stones dissolve.
"Uralit".

Nutritional Features

All patients must follow the diet prescribed by the doctor. Urolithiasis in men, depending on the type of stone, imposes certain dietary restrictions.

If the patient is found to have urates, then it is necessary to minimize the use of:

Purine-rich foods. These are fish, animal meat, mushrooms, offal, legumes, and meat broths. Such food is acceptable once a week.
Alcohol. Patients are prohibited from drinking red wine and beer.

Dietary nutrition should be based on the following foods:

sweet peppers, tomatoes, eggplants, potatoes;
mild cheese;
millet, buckwheat, barley;
fruits, berries;
pasta;
eggs;
milk, cottage cheese, fermented milk products.

Patients diagnosed with oxalates should limit their intake of the following foods:

spinach, lettuce, sorrel;
beets, carrots, tomatoes;
sauerkraut;
celery, parsley;
coffee Tea;
jelly, jellies;
chocolate, cocoa;
green bean;
chicken, beef;
currants, citrus fruits, sour apples.

dairy products;
whole grains, cereals;
potatoes, pumpkin, cabbage;
nuts;
apricots, bananas, pears, watermelons;
peas.

If phosphates are detected in the diet, you should limit:

cranberries, currants, lingonberries;
vegetables fruits;
fermented milk products, cottage cheese, cheese, dairy products;
alcohol;
hot spices;
carbonated drinks;
coffee.

The following foods are preferred in the diet:

various soups;
vegetable oil;
pasta, bread;
butter;
fish, meat;
fruit drinks and juices from sour berries and fruits (cranberries, citrus fruits, apples).

For cystine stones, the following foods should be excluded:

By-products - spleen, liver, kidneys.
Fish, meat. It is allowed to use no more than 3 days a week. The daily dose is 200-250 mg.
Eggs (you can only have one per day).
Wheat flour.
Legumes.

watermelons;
citrus;
cowberry;
grape;
strawberry;
raisin;
pomegranate;
olives;
pears;
currant;
carrot;
nuts;
blueberry.

Conclusion

If necessary, patients diagnosed with urolithiasis (urolithiasis) may be recommended special methods for crushing stones. As you can see, any pathology can be dealt with. The main thing is not to give up and strictly follow all the doctor’s prescriptions.

Urolithiasis (urolithiasis) is a disease that occurs as a result of a metabolic disorder in which an insoluble sediment in the form of sand (up to 1 mm in diameter) or stones (from 1 mm to 25 mm or more) is formed in the urine. Stones settle in the urinary tract, which disrupts the normal flow of urine and causes renal colic and inflammation.

According to medical statistics, urolithiasis is the second most common disease among all urological diseases, and in third place among urological diseases leading to death.

What it is?

Urolithiasis is chronic illness, which is caused by metabolic disorders and is accompanied by the formation of stones in the kidneys and urinary tract, formed from components urine. Its most common form is nephrolithiasis (kidney stone disease).

Causes

Urolithiasis is caused by various reasons:

sedentary lifestyle leading to metabolic disorders;
infectious and inflammatory diseases of organs genitourinary system which were caused by streptococcus, staphylococcus, coli, Proteus vulgaris;
other diseases of the kidneys and genitourinary system;
unbalanced diet, disrupted diet, too spicy, sour, salty foods in the diet;
lack of vitamins A and B;
drinking low-quality water with harmful chemical elements in the composition;
some drugs can increase the acidity of urine and affect kidney function;
unfavorable working conditions, accompanied by physically difficult work or work in the cold;
tumors in the bladder;
chronic gastrointestinal diseases (pancreatitis, gastritis and others);
chronic and protracted pathologies of the kidneys and urinary tract;
osteoporosis and other bone-related diseases;
genetic predisposition.

As for women, pregnancy also affects the development of urolithiasis. In women carrying a child, later The outflow of urine is often disrupted. The uterus enlarges, putting pressure on the kidneys. For this reason, urine can stagnate, causing the development of infectious diseases.

Classification

Basically, the pathogenesis of urolithiasis develops against the background of metabolic disorders in humans. This leads to the fact that some foods and substances are poorly processed and cannot be completely eliminated from the body. They accumulate as insoluble particles and result in sand or stones in the urine. Stones are classified according to their chemical composition. They come in several types:

Based on calcium (phosphates, carbonates). They are the most common (more than 60% of all stones).
Containing uric acid salts (urates). They can be dissolved and are found mainly in elderly patients.
Based on magnesium salts. Such stones provoke inflammation in the places where they are located.
Protein stones (cystine, cholesterol). These protein stones occur very rarely.

Examination of stones for their chemical composition is of great importance in treating illness and prescribing diet.

Symptoms of urolithiasis

Symptoms of urolithiasis in men occur only when a formed stone moves through the urethra. The pathological condition is characterized by a triad of clinical manifestations:

pain of varying severity;
changes in urinary sediment (appearance of blood, pus and other components);
disruption of the process of urine excretion, up to complete anuria (obstructive genesis).

The pain syndrome can be constant or intermittent, the degree of its severity varies from aching pain to unbearable renal colic, which requires emergency hospitalization patient to the hospital.

Painful symptoms are accompanied by complaints of a dysuric nature: increased frequency and painful urination, disruption of bladder emptying processes. Patients complain of general weakness, decreased performance, a feeling of nausea and vomiting at the peak of pain (it does not bring any relief).

The severity of symptoms of urolithiasis, depending on the location of the stone, is as follows:

The presence of a calculus in the lumen of the bladder is accompanied by pain in the lower abdomen, and the pain radiates to the genitals, perineum or rectum. There are typical dysuric disorders: frequent and painful urination, which can suddenly be interrupted (symptom of “stream interruption”).
When the stone is localized on different levels ureter, pain shifts to the groin area, and is characterized by irradiation to the surface of the thigh and genitals. There are complaints of frequent and painful urination. When a stone completely blocks the lumen of one of the ureters, the pain syndrome becomes unbearable (renal colic).
If the stone is localized in the pyelocaliceal apparatus of the kidney, then the patient has aching pain in the lumbar region of the corresponding side. Pain is associated with changes in body position and movement of the patient. Traces of blood in the urine often appear.

Often, patients go to the doctor with a stone that has already passed, which is an indisputable sign of urolithiasis.

Complications

The most common adverse outcomes of the disease are the following pathological processes:

calculous pyonephrosis (most often, purulent cavities in the kidney tissues occur with a recurrent form of urolithiasis);
inflammation of the affected kidney due to blockage of the urinary duct (obstructive form of pyelonephritis);
rupture of the wall of the ureter, bladder or urethra with the development of a septic condition in the patient;
acute renal failure(observed in patients with urolithiasis of a single kidney);
cicatricial deformations of the lumen of the ureter and others.

Diagnostics

In order to exclude complications from urolithiasis, urologists recommend not to delay visiting a doctor and to seek treatment at the first signs of the disease. medical care. To recognize the disease, determine the location of stones, their size, evaluate the functioning of the organs of the genitourinary system, a comprehensive differential diagnosis urolithiasis, which consists of the appointment of laboratory and instrumental methods examinations.

Instrumental diagnostics:

Intravenous excretory diagnostics.
X-ray – evaluates the kidneys, ureters and bladder, identifies stones.
CT or MRI of the kidneys – informative method diagnostics, which allows you to evaluate the functioning of the entire genitourinary system and identify the slightest disturbances in its functioning.
Ultrasound of the kidneys - visualizes all structures of the organ, determines the number of stones and other visible disturbances in the functioning of the urinary system.

Laboratory diagnostics:

Urinalysis - determines the pH of urine and the number of leukocytes. Urine tests for urolithiasis are carried out quite often, since they help identify salt crystals and recognize their composition.
Blood test - allows you to determine the presence of an inflammatory process, as evidenced by an increased ESR and the number of leukocytes.
Daily urine analysis - allows you to assess the content of various salts in urine.

Treatment of urolithiasis

ICD is a group of serious diseases that, if not properly treated, can lead to death. Self-medication for this disease is unacceptable, so at the first signs of the disease you should seek medical help. Any form of urolithiasis is treated comprehensively using:

medicines;
diet;
herbal medicine;
physiotherapy;
correct lifestyle;
ultrasonic crushing of stones;
removal of stones.

A conservative method of treating urolithiasis in men is carried out taking into account an integrated and systematic approach and involves taking certain medications.

Medicines are prescribed depending on the composition of the stones:

Citrate suppositories, diuretics and vitamins (if stones are of oxalate etiology);
Diuretics, anti-inflammatory and diphosphonates (if the detected stones are of phosphate etiology). With this course of ICD, many doctors recommend home treatment herbs as an adjuvant therapy;
Medicines that slow down the process of urea synthesis. Drugs are also prescribed that change the degree of acidity of urine, which leads to the dissolution of stones (in the presence of stones of urate etiology).

Drugs for the treatment of urolithiasis are divided into the following groups:

Painkiller medicine. Medicines relieve pain during an attack of renal colic (Tempalgin, Baralgin and others).
Antibiotics. Mandatory point of therapy. The antibiotic is selected individually by the urologist.
Medicines to help pass the stone. The purpose depends on the size, composition, location (Furosemide).
Antispasmodics. They remove the cause of the spasm, relax the walls of the ureter, facilitating the passage of the stone (Papaverine, No-shpa, Diprofen).
Drugs that dissolve stone. Selection of products based on the composition of the stone (“Fitolysin”, “Solimok”, “Urodan” and others, as well as dietary supplements - “Prolit”, “Litovit”).

The goal of drug therapy is to prevent exacerbation of urolithiasis, alleviate general state person, relax the muscles and walls of the ureter (kidney), dissolving possible stones and painless withdrawal.

Folk remedies

At home, in the absence of pain, and also to prevent relapses, you can use traditional methods. At phosphate stones the effect is observed with regular drinking of rosehip or barberry decoctions.

Combined ones are also used herbal teas, consisting of several herbs that have moderate diuretic, antispasmodic and uroseptic effects.

Combine the ingredients in the indicated quantities: garden parsley herb - 20 g, bearberry leaves, common juniper fruits, field steelhead root, dandelion root - 15 g each; common anise fruits, shepherd's purse herb - 10 g each. Pour 10 g of raw material in an enamel bowl with 1 cup of boiling water, close the lid and heat in a water bath for 30 minutes, leave for 10 minutes, strain, squeeze out the grounds. Increase the volume of the decoction boiled water up to 200 ml. Take 1/2-1/3 cup warm 2-3 times a day.
Tricolor violet herb - 30 g, horsetail herb - 30 g, St. John's wort herb - 25 g, dandelion herb - 25 g, buckthorn laxative root - 25 g; Brew a tablespoon of the crushed mixture with a glass of boiling water, leave for 30 minutes, strain and take a glass 3 times a day for phosphate and carbonate stones.
This method of removing stones involves taking two decoctions. The first decoction is prepared from rosehip roots. They need to be crushed using a coffee grinder to end up with 50 g of dry powder. Then add 700 ml of water to the powder and leave to simmer for 15 minutes. After this, prepare an infusion of bearberry. To do this, pour boiling water (300 ml) over dried or fresh herbs (about 30 g), leave for about 2 hours. You need to take the first remedy three times a day after meals, 300 ml. 25 minutes after consuming it, you should take 100 ml of bearberry infusion.
Mix the ingredients in the indicated proportions: greater celandine herb - 30 g, oregano herb - 20 g, barberry bark - 20 g; Pour a tablespoon of the mixture into a glass of boiling water, leave for 30 minutes and take a glass 3 times a day for uric acid stones.
Mix the ingredients in the indicated proportions: leaves and roots of stinging nettle - 50 g, licorice root - 30 g; pour a tablespoon of the mixture into a glass of boiling water, leave until cool, strain and drink in 3 doses during the day at kidney stone disease with jade.
The dissolution of sand and stones in the urinary organs is facilitated by fresh onions and garlic, strawberries, a decoction of melon seeds in milk, black radish juice with honey or sugar, infusions and decoctions of beans, peas, infusions of shepherd's purse leaves, black currants, fruits (fresh and dry) rose hips, rowan fruits, dandelion roots, calamus rhizomes, corn silks, horsetail grass (contraindicated for nephritis). Pumpkin is recommended cabbage pickle and juice, barberry, strawberry, rose hip.

List of recipes traditional medicine big. It is worth remembering that some herbs have contraindications, so when choosing a method of treatment with folk remedies, consultation with a doctor is required.

Surgical methods

Large urinary stones that cannot be dissolved are broken into small fragments, which either come out on their own or are removed surgically. Stones are destroyed by lithotripsy, affecting them with a shock wave.

There are several types of lithotripsy:

Contact lithotripsy - an endoscopic device is brought to the stone through the urethra and bladder, the active part of which comes into contact with the stone (which is why the method is called contact). A shock wave is formed at the point of contact.
Percutaneous lithotripsy - with this technique, a lithotripter is inserted into the kidney through an incision in the lumbar region. Used for crushing giant and coral-shaped stones.
ESWL - external shock wave lithotripsy - is a non-invasive method in which the impact on kidney stones is carried out without any skin incisions or other invasive techniques.

In cases where the stone cannot be crushed, surgery is performed. Depending on the volume of the operation, the following types of operations for urolithiasis are distinguished:

Nephrolithotomy - an incision is made directly through the kidney. This operation is indicated for stones that cannot be removed by other methods and when lithotripsy is ineffective. It is the most difficult operation for the patient.
Pyelolithotomy - a kidney stone is removed through a small incision in the renal pelvis.
Ureterolithotripsy is an operation to remove stones from the ureter.

Nutrition rules

Diet and nutrition for urolithiasis depends on the pH and composition of the stones. Depending on them, doctors have compiled a list of products whose consumption is contraindicated in a particular case.

If the stones are of urate origin, you should not take:

alcoholic drinks;
coffee;
meat broths;
fried and spicy foods;
offal;
chocolate, cocoa;
protein of animal origin.

If you have phosphate stones, you should not use:

vegetables with green skin and/or pulp;
any spices;
spicy dishes;
pumpkin, including its seeds;
legumes;
potato;
dairy products.

If you have oxalate stones, you should avoid using:

dairy products;
citrus fruits;
strawberries and wild strawberries;
lettuce leaves;
spinach;
legumes;
cheeses of any kind;
nuts;
sorrel;
cocoa, coffee and tea.

Compliance a certain regime nutrition is an integral part of the therapeutic program, which allows you to suspend further education stones in urinary system, as well as suppress the growth of existing stones.

Nutrition for urolithiasis is based on the following principles:

Don't overeat. Food that enters the stomach in large volumes will only worsen the situation.
Systematic consumption of food. Ideally, you should eat around the same time. It is not recommended to skip meals, as this can lead to increased stone formation and poor health.
Don't eat excessively high-calorie foods. The energy value of products must correspond to the energy costs that occur in reality.
The diet should be enriched with foods rich in vitamins and amino acids.
Drink about 2-3 liters of regular still water per day. This will increase the volume of urine excreted.

Prevention

When diagnosed with urolithiasis, prevention should be carried out much earlier than the first signs of the disease appear. Special attention People who are at risk or have chronic metabolic diseases should pay attention to their health.

Prevention of urolithiasis consists of following the following recommendations:

Consume clean water. In some regions, water contains large amounts of salts, which leads to increased concentrations in the urine and the formation of crystals. It is better to buy bottled water or use highly purified filters.
Maintain drinking regime. If there are no contraindications, a person should drink about 2 liters of liquid per day. The best option- this is pure drinking water. It is an ideal solvent and helps dilute the salts, preventing the formation of crystals and the formation of stones from them. People living in hot climates need to increase the volume to 3 liters.
Eat a balanced diet. Kidney stones are formed both in meat eaters who adhere to a protein diet, and in vegetarians who consume a lot of acidic vegetables and fruits. Therefore, nutrition should be varied and balanced in composition. It is recommended to eat 150-170 g of meat and 50 g of fish per day. It is not necessary to eat them every day, for example, you can fish 2 times a week for 300 g. You also need 300-400 g of vegetables and the same amount of fruits in any form every day. The total amount of cereals and bread should be 300-400 g.
Stay hydrated. Infectious diseases, burns, hot weather, prolonged physical activity and sports cause significant fluid loss. You must constantly replenish its reserves. To do this, it is advisable to drink frequently (every half hour), or in small portions of 100-150 ml. This will help reduce intoxication, remove harmful substances from the body and protect the kidneys.
Take vitamins. Deficiency of vitamins, especially E and group B, negatively affects the condition of the mucous membrane of the genitourinary organs and kidney function, and also leads to disruption of metabolic processes. Therefore, it is recommended to drink vitamin complexes 2 times per year.
Don't over-salt your food. For an adult, the daily salt requirement is 5 g or one teaspoon. This amount includes all the salt in the dishes you prepare and in the products (mayonnaise, herring, chips). Excess salt makes it difficult for the kidneys to function.
Come to fresh air. Ultraviolet deficiency has a bad effect on bone health. Minerals are washed out of them, which can take part in stone formation.
Treat diseases of the urinary system in a timely manner. Any inflammation can provoke the formation of stones and exacerbation of urolithiasis. Therefore, at the first symptoms, contact qualified help, and do not self-medicate.
Lead active image life. Lack of physical activity contributes to urinary stagnation. And exercises aimed at strengthening the abdominal muscles and lumbar region improve kidney function and eliminate congestion. Should become the daily norm hiking(30-40 minutes each) and a set of exercises lasting 15-20 minutes. The best option is to additionally visit the gym or pool 2-3 times a week.
Take herbal diuretics periodically. Watermelon, pomegranate juice, and a concentrated decoction of dried apricots (100 g per 0.5 liter of water) are suitable. Some medicinal herbs have a diuretic and anti-inflammatory effect: bear's ears, corn silk, horsetail and bearberry. They “wash” the kidneys, prevent salts from precipitating and remove small stones and sand that have already formed.
Take care of your digestive health. Deficiency of digestive enzymes in gastrointestinal diseases leads to the formation of calcium oxalate stones. Thus, in case of digestive disorders, ascorbic acid turns into oxalate, which is deposited in the kidneys in the form of crystals.
Avoid hypothermia. Keep your feet and lower back warm. The receptors located in these areas have a reflex connection with the kidneys and bladder. Hypothermia can cause inflammation or spasm of the smooth muscle around the stone.

Particular attention to prevention should be paid to people whose relatives suffer from urolithiasis. Since there is high probability that the tendency to form stones is inherited.

A metabolic disease caused by various causes, often hereditary, characterized by the formation of stones in the urinary system (kidneys, ureters, bladder or urethra). Stones can form at any level of the urinary tract, from the renal parenchyma, in the ureters, in the bladder and ending with the urethra.

The disease can be asymptomatic, manifested by pain of varying intensity in the lumbar region or renal colic.

The history of the names of urinary stones is very fascinating. For example, struvite (or tripyelophosphate), named after the Russian diplomat and naturalist G. H. von Struve (1772-1851). Previously, these stones were called guanites because they were often found in bats.

Stones made from calcium oxalate dihydrate (oxalates) are often called weddelites because. the same stones are found in rock samples taken from the bottom of the Weddell Sea in Antarctica.

Prevalence of urolithiasis

Urolithiasis has wide use, and in many countries of the world there has been a tendency towards an increase in incidence.

In the CIS countries there are areas where this disease is especially common:

Ural;
Volga region;
Don and Kama basins;
Transcaucasia.

Among foreign regions it is more common in such areas as:

Asia Minor;
Northern Australia;
North East Africa;
Southern regions of North America.

In Europe, urolithiasis is widespread in:

Scandinavian countries;
England;
the Netherlands;
South-East France;
South of Spain;
Italy;
Southern regions of Germany and Austria;
Hungary;
Throughout South-Eastern Europe.

In many countries of the world, including Russia, urolithiasis is diagnosed in 32-40% of cases of all urological diseases, and ranks second after infectious and inflammatory diseases.

Urolithiasis is detected at any age, most often in working age (20-55 years). In children's and old age- cases of primary detection are very rare. Men get sick 3 times more often than women, but staghorn stones are most often found in women (up to 70%). In most cases, stones form in one of the kidneys, but in 9-17% of cases, urolithiasis is bilateral.

Kidney stones can be single or multiple (up to 5000 stones). The size of the stones is very different - from 1 mm, to giant ones - more than 10 cm and weighing up to 1000 g.

Causes of urolithiasis

Currently, there is no unified theory of the causes of the development of urolithiasis. Urolithiasis is a multifactorial disease, has complex, diverse development mechanisms and various chemical forms.

The main mechanism of the disease is considered to be congenital - a slight metabolic disorder, which leads to the formation of insoluble salts that form into stones. By chemical structure distinguish between different stones - urates, phosphates, oxalates, etc. However, even if there are congenital predisposition to urolithiasis, it will not develop if there are no predisposing factors.

The formation of urinary stones is based on the following metabolic disorders:

hyperuricemia (increased levels of uric acid in the blood);
hyperuricuria (increased levels of uric acid in the urine);
hyperoxaluria (increased levels of oxalate salts in the urine);
hypercalciuria (increased levels of calcium salts in the urine);
hyperphosphaturia (increased levels of phosphate salts in the urine);
change in urine acidity.

In the occurrence of these metabolic changes, some authors give preference to the effects external environment(exogenous factors), others - endogenous reasons, although their interaction is often observed.

Exogenous causes of urolithiasis:

climate;
geological soil structure;
chemical composition of water and flora;
food and drinking regime;
living conditions (monotonous, sedentary lifestyle and recreation);
working conditions (hazardous industries, hot workshops, heavy physical work and etc.).

Food and drinking regimes of the population - total calorie content of food, abuse of animal protein, salt, products containing large quantities calcium, oxalic and ascorbic acids, lack of vitamins A and B in the body play a significant role in the development of KSD.

Endogenous causes of urolithiasis:

infections of both the urinary tract and outside the urinary system (tonsillitis, furunculosis, osteomyelitis, salpingoophoritis);
metabolic diseases (gout, hyperparathyroidism);
deficiency, absence or hyperactivity of a number of enzymes;
severe injuries or illnesses associated with prolonged immobilization of the patient;
diseases of the digestive tract, liver and biliary tract;
hereditary predisposition to urolithiasis.

Factors such as gender and age play a certain role in the genesis of urolithiasis: men are affected 3 times more often than women.

Along with the general causes of an endogenous and exogenous nature in the formation of urinary stones, the undeniable importance is also local changes urinary tract (developmental anomalies, additional vessels, narrowing, etc.), causing disturbance their functions.

Symptoms of urolithiasis

Most characteristic symptoms urolithiasis are:

pain in the lumbar region- can be constant or periodic, dull or acute. The intensity, localization and radiation of pain depend on the location and size of the stone, the degree and severity of obstruction, as well as the individual structural characteristics of the urinary tract.

Large pelvic stones and coral kidney stones are inactive and cause dull pain, often permanent, in the lumbar region. Urolithiasis is characterized by an association of pain with movement, shaking, riding, and heavy physical activity.

For small stones, attacks of renal colic are most typical, which is associated with their migration and a sharp disruption of the outflow of urine from the calyx or pelvis. Pain in the lumbar region often radiates along the ureter, to the iliac region. As stones move into the lower third of the ureter, the irradiation of pain changes; they begin to spread lower into the groin area, into the testicle, glans penis in men and labia in women. An imperative urge to urinate, frequent urination, and dysuria appear.

renal colic - paroxysmal pain caused by a stone, occurs suddenly after driving, shaking, drinking too much liquid, or drinking alcohol. Patients constantly change position, cannot find a place for themselves, often moan and even scream. This characteristic behavior of the patient often makes it possible to establish a diagnosis “at a distance.” The pain sometimes continues for several hours or even days, periodically subsiding. The cause of renal colic is a sudden disruption of the outflow of urine from the calyces or pelvis caused by occlusion (of the upper urinary tract) by a stone. Quite often, an attack of renal colic can be accompanied by chills, fever, and leukocytosis.
nausea, vomiting, bloating, abdominal muscle tension, hematuria, pyuria, dysuria- symptoms often accompanying renal colic.
spontaneous stone passage
rarely - obstructive anuria(with a solitary kidney and bilateral ureteral stones)

In children, none of these symptoms are typical for urolithiasis.

Kidney calyx stones

Obstruction and renal colic can be caused by caliceal stones.

For small stones, pain usually occurs intermittently during transient obstruction. The pain is dull, varies in intensity and is felt deep in the lower back. It may intensify after drink plenty of fluids. In addition to obstruction, the cause of pain may be inflammation of the renal calyx due to infection or accumulation of tiny crystals of calcium salts.

Kidney calyx stones are usually multiple, but small, so they should pass spontaneously. If the stone remains in the renal calyx despite the flow of urine, then the likelihood of obstruction is very high.

Pain caused by small caliceal stones usually disappears after extracorporeal lithotripsy.

Renal pelvis stones

Renal pelvis stones with a diameter of more than 10 mm. usually cause obstruction of the ureteropelvic segment. In this case, severe pain occurs in the costovertebral angle below the 12th rib. The nature of the pain varies from dull to excruciatingly acute, its intensity is usually constant. The pain often radiates to the lateral abdomen and hypochondrium. It is often accompanied by nausea and vomiting.

A coral-shaped stone that occupies the entire renal pelvis or part thereof, does not always cause urinary tract obstruction. Clinical manifestations are often scant. Only mild pain in the lower back is possible. In this regard, coral stones are a finding during examination for recurrent urinary tract infections. If left untreated, they can lead to serious complications.

Stones of the upper and middle part of the ureter

Stones in the upper or middle third of the ureter often cause severe sharp pain in the lower back.

If the stone moves along the ureter, periodically causing obstruction, the pain is not constant, but more intense.

If the stone is immovable, the pain is less intense, especially with partial obstruction. With immovable stones that cause severe obstruction, compensatory mechanisms are activated that reduce pressure on the kidney, thereby reducing pain.

With a stone upper third ureter pain radiates to the lateral parts of the abdomen, with a stone in the middle third - to the iliac region, in the direction from the lower edge of the ribs to the inguinal ligament.

Lower ureteral stones

Pain from a stone in the lower third of the ureter often radiates to the scrotum or vulva. The clinical picture may resemble testicular torsion or acute epididymitis.

A stone located in the intramural portion of the ureter (at the level of the entrance to the bladder) at clinical manifestations reminds acute cystitis, acute urethritis or acute prostatitis, since it may cause pain in the suprapubic region, frequent, painful and difficult urination, urgency, gross hematuria, and in men - pain in the area of the external opening of the urethra.

Bladder stones

Bladder stones are mainly manifested by pain in the lower abdomen and suprapubic region, which can radiate to the perineum and genitals. Pain occurs when moving and urinating.

Another manifestation of bladder stones is increased urination. Sharp, causeless urges appear when walking, shaking, physical activity. During urination, the so-called “stacking” symptom may be observed - suddenly the stream of urine is interrupted, although the patient feels that the bladder is not completely emptied, and urination resumes only after a change in body position.

In severe cases, with very large stone sizes, patients can only urinate while lying down.

Signs of urolithiasis

Manifestations of urolithiasis may resemble symptoms of other diseases of the abdominal cavity and retroperitoneal space. That is why the urologist first of all needs to exclude such manifestations acute abdomen, such as acute appendicitis, uterine and ectopic pregnancy, cholelithiasis, peptic ulcer etc., which sometimes needs to be done together with doctors of other specialties. Based on this, determining the diagnosis of ICD can be difficult and lengthy, and includes the following procedures:

1. Examination by a urologist, clarification of a detailed history in order to maximize understanding of the etiopathogenesis of the disease and correction of metabolic and other disorders for the prevention of the disease and metaphylaxis of relapses. Important points This stage is to clarify:

type of activity;
time of onset and nature of the course of urolithiasis;
previous treatment;
family history;
nutrition style;
a history of Crohn's disease, bowel surgery, or metabolic disorders;
drug history;
presence of sarcoidosis;
the presence and nature of the course of urinary infection;
the presence of anomalies of the genitourinary organs and operations on the urinary tract;
a history of trauma and immobilization.

2. Visualization of the stone:

performing survey and excretory urography or spiral computed tomography.

3. Clinical analysis blood, urine, urine pH. Biochemical research blood and urine.
4. Urine culture on microflora and determination of its sensitivity to antibiotics.
5. If necessary, carried out calcium stress tests(differential diagnosis of hypercalciuria) and ammonium chloride (diagnosis of renal tubular acidosis), parathyroid hormone test.
6. Stone analysis(if available).
7. Biochemical and radioisotope kidney function tests.
8. Retrograde ureteropyelography, ureteropyeloscopy, pneumopyelography.
9. Study of stones by tomographic density(used to predict the effectiveness of lithotripsy and prevent possible complications).

Treatment of urolithiasis

How to get rid of stones

Due to the fact that the causes of urolithiasis are not fully understood, removing a kidney stone operationally does not mean the patient's recovery.

Treatment of people suffering from urolithiasis can be either conservative or surgical.

The general principles of treatment of urolithiasis include 2 main areas: destruction and/or elimination of stones and correction of metabolic disorders. Additional Methods Treatments include: improvement of microcirculation in the kidneys, adequate drinking regimen, sanitation of the urinary tract from existing infections and residual stones, diet therapy, physiotherapy and sanatorium treatment.

After establishing a diagnosis, determining the size of the stone, its location, assessing the state of urinary tract patency and kidney function, as well as taking into account concomitant diseases and previous treatment, you can begin to choose optimal method treatment to rid the patient of the existing stone.

Stone elimination methods:

various conservative methods treatments that promote stone passage for small stones;
symptomatic treatment, which is most often used for renal colic;
surgical removal of a stone or removal of a kidney with a stone;
medicinal litholysis;
"local" litholysis;
instrumental removal of stones descended into the ureter;
percutaneous removal of kidney stones by extraction (litholapoxia) or contact lithotripsy;
ureterolitholapoxia, contact ureterolithotripsy;
extracorporeal lithotripsy (ESLT);

All of the above methods of treating urolithiasis are not competitive and do not exclude each other, and in some cases are complementary. However, it can be said that the development and implementation of extracorporeal lithotripsy (ESLT), the creation of high-quality endoscopic technology and equipment were revolutionary events in urology at the end of the twentieth century. It was thanks to these epoch-making events that the beginning of minimally invasive and low-traumatic urology was laid, which today is developing with great success in all areas of medicine and has reached its epoch associated with the creation and widespread implementation of robotics and telecommunication systems.

Emerging minimally invasive and low-impact methods treatment of urolithiasis radically changed the mentality of a whole generation of urologists, distinctive feature the current essence of which is that regardless of the size and location of the stone, as well as its “behavior,” the patient should and can be freed from it! And this is correct, since even small, asymptomatic stones located in the calyces must be eliminated, since there is always a risk of their growth and the development of chronic pyelonephritis.

Currently, the most widely used methods for the treatment of urolithiasis are extracorporeal lithotripsy (ESLT), percutaneous nephrolithotripsy (-lapaxy) (PNL), and ureterorenoscopy (URS), due to which the number of open operations has been reduced to a minimum, and in most clinics in Western Europe - to zero.

Diet for urolithiasis

The diet of patients with urolithiasis includes:

drinking at least 2 liters of fluid per day;
depending on the identified metabolic disorders and the chemical composition of the stone, it is recommended to limit the intake of animal protein, table salt, and foods containing large amounts of calcium, purine bases, oxalic acid;
Consuming foods rich in fiber has a positive effect on metabolism.

Physiotherapy for urolithiasis

In a comprehensive conservative treatment patients with urolithiasis include the appointment of various physiotherapeutic methods:

sinusoidal modulated currents;
dynamic amplipulse therapy;
ultrasound;
laser therapy;
inductothermy.

In the case of using physiotherapy in patients with urolithiasis complicated by urinary tract infection, it is necessary to take into account the phases of the inflammatory process (indicated for latent course and in remission).

Sanatorium-resort treatment for urolithiasis

Sanatorium-resort treatment is indicated for urolithiasis both in the absence of a stone (after its removal or spontaneous passage) and in the presence of a stone. It is effective for kidney stones, the size and shape of which, as well as the condition of the urinary tract, allow us to hope for their spontaneous passage under the influence of the diuretic effect of mineral waters.

Patients with uric acid and calcium oxalate urolithiasis are treated at resorts with low-mineralized alkaline mineral waters:

Zheleznovodsk (“Slavyanovskaya”, “Smirnovskaya”);
Essentuki (Essentuki No. 4, 17);
Pyatigorsk, Kislovodsk (Narzan).

For calcium oxalate urolithiasis, treatment at the Truskavets (Naftusya) resort, where the mineral water is slightly acidic and low-mineralized, may also be indicated.

Treatment at resorts is possible at any time of the year. The use of similar bottled mineral waters does not replace a stay at the resort.

Taking the above mineral waters, as well as Tib-2 mineral water (North Ossetia) for therapeutic and prophylactic purposes is possible in an amount of no more than 0.5 l/day under strict laboratory control of the metabolic parameters of stone-forming substances.

Treatment of uric acid stones

dissolution of stones (litholysis).

The following medications are used in the treatment of uric acid stones:

Allopurinol (Allupol, Purinol) - up to 1 month;
Blemaren - 1-3 months.

Treatment of calcium oxalate stones

At drug treatment urolithiasis, the doctor sets the following goals:

prevention of stone formation recurrence;
prevention of the growth of the stone itself (if it already exists);
dissolution of stones (litholysis).

For urolithiasis, step-by-step treatment is possible: if diet therapy is ineffective, additional medications must be prescribed.

One course of treatment usually lasts 1 month. Depending on the results of the examination, treatment may be resumed.

The following medications are used in the treatment of calcium oxalate stones:

Pyridoxine (vitamin B 6) - up to 1 month;
Hypothiazide - up to 1 month;
Blemaren - up to 1 month.

Treatment of calcium phosphate stones

When treating urolithiasis with medication, the doctor sets the following goals:

prevention of stone formation recurrence;
prevention of the growth of the stone itself (if it already exists);
dissolution of stones (litholysis).

For urolithiasis, step-by-step treatment is possible: if diet therapy is ineffective, additional medications must be prescribed.

One course of treatment usually lasts 1 month. Depending on the results of the examination, treatment may be resumed.

The following medications are used in the treatment of calcium phosphate stones:

Antibacterial treatment - in the presence of infection;
Magnesium oxide or aspartate - up to 1 month;
Hypothiazide - up to 1 month;
Herbal medicines (plant extracts) - up to 1 month;
Boric acid - up to 1 month;
Methionine - up to 1 month.

Treatment of cystine stones

When treating urolithiasis with medication, the doctor sets the following goals:

prevention of stone formation recurrence;
prevention of the growth of the stone itself (if it already exists);
dissolution of stones (litholysis).

For urolithiasis, step-by-step treatment is possible: if diet therapy is ineffective, additional medications must be prescribed.

One course of treatment usually lasts 1 month. Depending on the results of the examination, treatment may be resumed.

The following medications are used in the treatment of cystine stones:

Ascorbic acid (vitamin C) - up to 6 months;
Penicillamine - up to 6 months;
Blemaren - up to 6 months.

Complications of urolithiasis

Prolonged standing of the stone without a tendency to pass on its own leads to progressive inhibition of the function of the urinary tract and the kidney itself, up to its (kidney) death.

The most frequent complications urolithiasis are:

Chronic inflammatory process at the location of the stone and the kidney itself (pyelonephritis, cystitis), which, under unfavorable conditions (hypothermia, acute respiratory infections), can worsen ( acute pyelonephritis, acute cystitis).
In turn, acute pyelonephritis can be complicated by paranephritis, the formation of pustules in the kidney (apostematous pyelonephritis), a carbuncle or abscess of the kidney, necrosis of the renal papillae and, ultimately, sepsis (fever), which is an indication for surgical intervention.
Pyonephrosis is the terminal stage of purulent-destructive pyelonephritis. The pyonephrotic kidney is an organ that has undergone purulent melting, consisting of separate cavities filled with pus, urine and tissue decay products.
Chronic pyelonephritis leads to rapidly progressing chronic renal failure and, ultimately, to nephrosclerosis.
Acute renal failure is extremely rare due to obstructive anuria with a solitary kidney or bilateral ureteral stones.
Anemia due to chronic blood loss (hematuria) and impaired renal hematopoietic function.

Prevention of urolithiasis

Preventive therapy aimed at correcting metabolic disorders is prescribed according to indications based on examination data of the patient. The number of courses of treatment during the year is determined individually under medical and laboratory supervision.

Without prevention for 5 years, in half of the patients who got rid of stones using one of the treatment methods, urinary stones form again. Patient education and prevention itself are best started immediately after spontaneous passage or surgical removal stone

Lifestyle:

fitness and sports (especially for professions with low physical activity), however excessive exercise should be avoided in untrained people
avoid drinking alcohol
avoid emotional stress
Urolithiasis is often found in obese patients. Losing weight by reducing consumption high-calorie food reduce the risk of disease.

Increasing fluid intake:

Indicated for all patients with urolithiasis. In patients with urine density less than 1.015 g/l. stones form much less frequently. Active diuresis promotes the removal of small fragments and sand. Optimal diuresis is considered to be 1.5 liters. urine per day, but in patients with urolithiasis it should be more than 2 liters per day.

Calcium intake.

Higher calcium intake reduces oxalate excretion.

Fiber consumption.

Indications: calcium oxalate stones.
You should eat vegetables and fruits, avoiding those rich in oxalate.

Oxalate retention.

Low levels of dietary calcium increase oxalate absorption. When dietary calcium levels increased to 15-20 mmol per day, urinary oxalate levels decreased. Ascorbic acid and vitamin D may contribute to increased oxalate excretion.
Indications: hyperoxaluria (oxalate concentration in urine more than 0.45 mmol/day).
Reducing oxalate intake may be beneficial in patients with hyperoxaluria, but in these patients, oxalate retention must be combined with other treatments.
Limiting foods rich in oxalates if you have calcium oxalate stones.

Foods rich in oxalates:

Rhubarb 530 mg/100 g;
Sorrel, spinach 570 mg/100 g;
Cocoa 625 mg/100 g;
Tea leaves 375-1450 mg/100 g;
Nuts.

Vitamin C intake:

Vitamin C intake of up to 4 g per day can occur without the risk of stone formation. More high doses promote endogenous metabolism ascorbic acid into oxalic acid. At the same time, the excretion of oxalic acid by the kidneys increases.

Reducing protein intake:

Animal protein is considered one of the important factors risk of stone formation. Excessive use may increase calcium and oxalate excretion and decrease citrate excretion and urine pH.
Indications: calcium oxalate stones.
It is recommended to take approximately 1g/kg. protein weight per day.

Thiazides:

The indication for thiazides is hypercalciuria.
Drugs: hypothiazide, trichlorothiazide, indopamide.
Side effects:

mask normocalcemic hyperparathyroidism;
development of diabetes and gout;
erectile disfunction.

Orthophosphates:

There are two types of orthophosphates: acidic and neutral. They reduce calcium absorption and calcium excretion as well as they reduce bone reabsorption. In addition, they increase the excretion of pyrophosphate and citrate, which increases the inhibitory activity of urine. Indications: hypercalciuria.
Complications:

diarrhea;
abdominal cramps;
nausea and vomiting.

Orthophosphates can be an alternative to thiazides. Used for treatment in selected cases, but cannot be recommended as a first-line treatment. They should not be prescribed for stones associated with a urinary tract infection.

Alkaline citrate:

Mechanism of action:

reduces supersaturation of calcium oxalate and calcium phosphate;
inhibits the process of crystallization, growth and aggregation of stone;
reduces supersaturation of uric acid.

Indications: calcium stones, hypocitraturia.

Magnesium:

Indications: calcium oxalate stones with or without hypomagniuria.
Side effects:

diarrhea;
CNS disorders;
fatigue;
drowsiness;

Magnesium salts cannot be used without using citrate.

Glycosaminoglycans:

Mechanism of action: calcium oxalate crystal growth inhibitors.
Indications: calcium oxalate stones.