How is urolithiasis. Urolithiasis in women: symptoms and treatment, folk remedies

The kidneys around the clock cleanse our body of various harmful and unnecessary products. Every 7-8 minutes the blood of each person completely passes and is filtered through them. Unfortunately, in the work of the kidneys, however, like any other organs, 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, we will talk with the editors of the site www.site about the causes of urolithiasis and its development.

The formation of stones occurs not only in diseases of the internal organs, but also from some environmental factors.

Gradual deposits of salts around any particle, for example, a microorganism, lead to the appearance of stones in the ureters and kidneys. Being for a long time in one place and blocking, thereby, the outflow of urine, the stones make changes in the urinary tract. This may be a local expansion of the ureter or kidney, as well as a malnutrition 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 is the violation metabolic processes V human body- fat, mineral or protein metabolism, as a result of which excess substances are formed that precipitate. Metabolic processes can be both a consequence of diseases and an independent state.

Impaired outflow of urine from the kidneys through the ureters bladder and further from it to the urethra is an important factor in the development of KSD. With such a violation, a reverse reflux of urine against the current may occur or its stagnation in the bladder or kidneys, 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.

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

External factors affecting the development of urolithiasis:

Excess content in food table salt;

Lack of fluid;

Abuse of various spices containing salt;

The use of a large number of smoked foods and alcoholic beverages;

Long-term self-administration of drugs such as aspirin, antibiotics, hormonal drugs, means that help reduce the acidity of the gastrointestinal juice;

Chronic pyelonephritis.

The latter cause 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 stones.

The composition of the stones can vary and be phosphate, urate, carbonate and oxalate. In the renal pelvis, several stones can form at the same time. During interictal period urolithiasis can occur without any special symptoms, the patient usually has no complaints.

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

Currently urolithiasis diagnosed with the help of ultrasound examination of the kidneys, radiography, as well as a general urine test.

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

How to deal with kidney stones at home

Urolithiasis can be considered the leader among kidney pathologies. The disease begins with the formation of microliths, that is, "sand" in the kidneys, from which stones are then formed. If the stone is large in size, when moving it can clog the ureter, the outflow of new urine will occur in the kidney, the body will not be cleansed. The result is often hydronephrosis - a severe urolithiasis. In order not to face such consequences, it is important to know about the basic principles and methods of treating KSD, which can be done independently at home.

Briefly about the ICD

Statistics show that the risk of kidney stones for men is three times higher than for women. However, big coral stones more often formed precisely in the representatives of the fair half. The accumulation of stones is often in one kidney, but one in seven or ten patients can be diagnosed with bilateral KSD. In this case, the disease affects in some cases, in addition to the kidneys, the ureters with the bladder.

Types of stones in ICD

Calcium phosphate stones are called stones of white or light gray color with a smooth or slightly rough surface, rather soft in texture. This type of stones is formed if there is a lot of phosphorus with calcium in the urine.

When there are many salts of oxalic acid or oxalates in the urine, calcium-oxalate stones appear, rather dense, with spike-like outgrowths on the surface. Color of stones - gray-black

You can distinguish urate stones by their yellow color with a brick tint, smooth surface and hardness. It is important in the case of the formation of such stones to normalize the amount uric acid.

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

Sometimes stones can consist of magnesium, ammonium, calcium, phosphates. The reason for their development in the body is bacteria that have entered the genitourinary tract and produce urease there, that is, an enzyme that breaks down 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.

There are several other types of stones. For example, calcium carbonate, which are white, smooth and soft. Also soft and white in color are the protein stones of the urinary system. Soft, but black in color - cholesterol stones.

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

General rules of treatment

Drink more. This will help not to accumulate urine in the body, which means not to increase the size of those stones that are, not to form new ones. If you have nephrolithiasis, you need to drink several liters of water per day. According to the diet, it is worth focusing 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, cope with the "stagnation" of harmful substances.

Specialists also refer to the general principles of treatment for stone removal using surgical and conservative methods. Their appointment, of course, is individual.

Features of treatment for different types of stones

It is worth limiting cocoa-containing foods if you have calcium oxalate stones. Eliminate coffee with tea, spinach, sorrel, lettuce, strawberries, nuts, citrus fruits, cheese, legumes, fermented milk products. It is better not to eat during treatment blackcurrant. 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, meat broths will help to cope with uric acid stones. Among the mineral waters, the following are especially useful: alkaline (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, cottage cheese for some time.

Ways to prevent KSD

To help the 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 body weight, monitor the amount of calories and salt that the body receives. Let drinking herbal teas and decoctions become a good habit.

Urolithiasis disease(ICD) is a pathology that is always accompanied by pain. Uncomfortable sensations are often localized in the lower back. But if the exit, the pain can be felt in the entire abdomen. Such symptoms often underlie the misdiagnosis and make the patient suspect appendicitis or an ulcer. Therefore, we will consider what are the symptoms and treatment in men with the diagnosis of "urolithiasis".

What underlies the disease?

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

The causes of pathology are divided into two groups: external and internal factors. Let's consider them.

External factors leading to the formation of stones:

Climate features. Dry air often leads to dehydration.
Soil structure. It affects the electrolyte content of foods.
Water. With urolithiasis, the source of pathology can be an excess of salts in the fluid consumed. This leads to a high concentration of them in the urine. In addition, stone formation is affected by the acidity of the water.
Daily regime. Hypodynamia contributes to the development of pathology.
Lack of fluid. A small amount of water consumed seriously increases the risk of disease.
Diet. Excess 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 affect the development of such a pathology 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, ureters.

Symptoms of the disease

No specific clinical manifestations initial stages does not have urolithiasis. Symptoms and treatment in men are often absent during this period. Pathology can be detected if other diseases are diagnosed.

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

She has the following features:

Attack-like severe pain, which periodically worsens.
An increase in temperature may occur.
Painful discomfort appears suddenly, often during shaking, movement, or after a large amount of fluid taken, alcohol. Changing the position of the body does not eliminate pain.
Discomfort can spread to the lumbar region, lower abdomen, 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 in the lumbar region (near 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 high. Painful discomfort occurs as a result of stretching of the kidney capsule.
A moving stone always calls pain. The ball radiates, as a rule, to the anterior region of the thigh and scrotum.
Pain is persistent. Sometimes the patient has periods of relief, which are replaced by exacerbation. This symptomatology is typical for the localization

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

dysuria;
worsening of the patient's condition;
elevated temperature;
hematuria;
nausea, vomiting;
urinary retention due to blockage of the bladder neck.

Diagnosis of the disease

To confirm the diagnosis, the patient's urolithiasis is studied very carefully by the attending physician. The doctor is interested in the past treatment, its effectiveness. Such measures make it possible to correctly prescribe adequate therapy.

The diagnosis is made as a result of the following data:

The patient has characteristic symptoms. Intermittent sharp pains in lumbar region, abdomen or groin. Incomplete emptying of the bladder. Burning sensation during urination in the urethra.
inspection data. The doctor feels the abdomen, as a result of which inflammatory pathologies of the peritoneum, such as pancreatitis, cholecystitis, appendicitis, are excluded. tapping lumbar zone and abdomen makes it possible to differentiate the pathology from lumbago, sciatica, pyelonephritis. An external examination of the patient can characterize many. The patient's posture, skin color, and the presence of swelling are taken into account.
Characteristic for pathology indicators of the general analysis of urine. As a rule, increased density is detected. Unaltered erythrocytes are found in the urine. High concentration of salts is noted. Such indicators of the general analysis of urine characterize the presence of urolithiasis in the patient.
Ultrasound data. This survey With high precision determines the diagnosis and gives an idea of the size, shape and localization of stones.
CT results. The examination is used if the ultrasound did not give a complete description of the pathology.
The results of radiopaque examination. This method allows you to examine the flow of urine in detail. Diagnostics reveals where the blockage of the ducts occurred.

Varieties of stones

It is very important not only to determine such a pathology as urolithiasis. Symptoms and treatment in men are completely dependent on the type of calculus. 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 with urolithiasis:

Oxalate. Such stones are formed from calcium salt. They are distinguished by a high density, spiky surface. Initially, their color is black and gray. If the stone injures the mucous membrane, it acquires a black or dark brown hue due to the blood pigment.
Phosphate. They contain the calcium salt of phosphoric acid. As a rule, the stone is smooth or slightly rough. It can take on a variety of forms. The texture of the stone is soft. It is distinguished by light gray or white color. This 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 firm texture. Crushing is possible with the help of medications.
Carbonate. They contain the calcium salt of carbonic acid. The consistency of the stones is soft, and the shape is diverse. 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, soft texture.
Protein. Their formation is facilitated by fibrin with an admixture of bacteria and salts. stones white color, small, soft and flat.
Cholesterol. They are extremely rare in the kidneys. Consist of cholesterol, have a soft texture, differ in black color. Such calculi are dangerous because they crumble easily.

Treatment of the disease

The tactics of dealing with pathology is determined by the urologist. For treatment, surgical methods and conservative therapy are used. Choice necessary way depends on the patient's condition, his age, size and location of the stone, the clinical course of the pathology, the presence of physiological or anatomical changes and stages of renal failure.

In most cases, surgery is required to remove the stones. The exception is calculi formed by uric acid. These stones can be dissolved with conservative treatment.

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

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

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

Dissolution of urates

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

The following drugs are used to treat urates:

Allopurinol, Allozim, Allopron, Allupol, Zilorik, Milurit, Remid, Sanfipurol, Purinol. Such medicines help to reduce the deposition of uric acid salts.
"Etamid". The drug stimulates the intensive excretion of urates along with urine. Helps reduce uric acid in the body.
"Urodan". Combined drug that causes alkalization of urine. The drug promotes the formation of soluble salts with uric acid.
"Uralit U". The tool is used to dissolve urates. Protects the body from the formation of new stones.
"Blemarin". The drug is able to dissolve urates and some other urinary stones.
"Solimok". Perfectly dissolves urinary stones, mainly urates.

Dissolution of oxalates

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

"Marlin".
"Spilled". herbal preparation, which contributes to the dissolution of oxalate stones.
Medicinal collections No. 7; No. 8; No. 9; No. 10. Such funds are officially recognized by urology. They have diuretic, litholytic (dissolving stones), antispasmodic properties.

Dissolution of phosphates

To combat this pathology, the drugs most in demand are:

"Extract of madder dye". This tool allows you to loosen the phosphates. In addition, the drug has an antispasmodic and diuretic effect.
"Marlin". The drug not only softens the stones, but also perfectly eliminates the spasm of the renal pelvis, ureter. The medicine relieves inflammation in the genitourinary system.

Dissolution of cystine stones

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

"Penicillamine". The agent forms a specific compound with cystine, which is easily dissolved in the urine. This allows you to reduce the stones.
"Thiopronin". The effect on the body of the drug is similar to the above medicine. It is prescribed if "Penicillamine" was ineffective.
"Potassium citrate", "Sodium bicarbonate". Medications that alkalize urine. As a result, cystine stones dissolve.
"Uralit".

Nutrition Features

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

If a patient has urates, then it is necessary to minimize the use of:

Foods rich in purines. These are fish, animal meat, mushrooms, offal, legumes, meat broths. Such food is allowed 1 time per week.
Alcohol. Patients are forbidden to drink red wine, beer.

Diet food should be based on the following food:

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

Patients who are diagnosed with oxalates should limit the use of the following products:

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.

When detecting phosphates in the diet, you should limit:

cranberries, currants, cranberries;
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 sour berries and fruits (cranberries, citrus fruits, apples).

With cystine stones, the following foods are to be excluded:

Offal - 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 (only one per day).
Wheat flour.
Legumes.

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

Conclusion

If necessary, patients with a diagnosis of ICD (urolithiasis) can 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 precipitate forms in the urine in the form of sand (up to 1 mm in diameter) or stones (from 1 mm to 25 mm and more). Stones settle in the urinary tract, which disrupts the normal outflow of urine and causes renal colic and inflammation.

According to medical statistics, urolithiasis ranks second in frequency 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 a metabolic disorder and is accompanied by the formation of stones in the kidneys and urinary tract, formed from constituent parts urine. Its most common form is nephrolithiasis (kidney stones).

Causes

Urolithiasis is provoked by various reasons:

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

As for women, pregnancy also affects the development of urolithiasis. In women who are carrying a child, later dates urine outflow is often disturbed. The uterus enlarges, pressing on the kidneys. For this reason, urine can stagnate, provoking 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 products and substances are poorly processed and cannot completely leave 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 are of several types:

Based on calcium (phosphates, carbonates). They are the most common (more than 60% of all stones).
Containing uric acid salts (urates). They are dissolvable and occur mainly in elderly patients.
Based on magnesium salts. Such stones provoke inflammation in the places of their localization.
Protein stones (cystine, cholesterol). These protein stones are very rare.

The study of calculi for their chemical composition is of great importance in the treatment of the disease, the appointment of a diet.

Symptoms of urolithiasis

There are symptoms of urolithiasis in men only at the time of the movement of the formed stone along the urethra. The pathological condition is characterized by a triad of clinical manifestations:

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

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

Complaints of a dysuric nature join the pain symptoms: rapid and painful urination, violation of the processes of emptying the bladder. Patients complain of general weakness, decreased performance, 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 localization of the calculus, is as follows:

The presence of a calculus in the lumen of the bladder is accompanied by pain in the lower abdomen, while the pain radiates to the genitals, perineum or rectum. There are typical dysuric disorders: frequent and painful urination, which can be interrupted suddenly (symptom of "interruption of the jet").
When localizing the calculus on different levels ureter pain is shifted to the inguinal region, its irradiation to the surface of the thigh and genitals is characteristic. There are complaints of frequent and painful urination. When the 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 pains in the lumbar region of the corresponding side. Pain is associated with a change in body position and movement of the patient. Often there are traces of blood in the urine.

Often, patients go to the doctor with a stone that has already passed away, 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 tissues of the kidney occur with a recurrent form of urolithiasis);
inflammation of the affected kidney against the background of 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 kidney failure(observed in patients with urolithiasis of a single kidney);
cicatricial deformities of the lumen of the ureter and others.

Diagnostics

In order to exclude complications from urolithiasis, urologists recommend not to hesitate to visit a doctor and, at the first signs of the disease, apply for medical care. To recognize the disease, determine the localization of stones, their size, evaluate the work of the organs of the genitourinary system 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, recognizes stones.
CT or MRI of the kidneys - informative method diagnostics, which allows you to evaluate the work of the entire genitourinary system, to identify the slightest violations in its work.
Ultrasound of the kidneys - visualizes all the structures of the organ, determines the number of stones and other visible disorders in the urinary system.

Laboratory diagnostics:

Urinalysis - determines the pH of urine, the number of leukocytes. Urine tests for urolithiasis are carried out quite often, since they help to 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 of a person. Self-medication for this disease is unacceptable, therefore, at the first signs of the disease, you need to seek medical help. Any form of urolithiasis is treated in a complex with the use of:

medicines;
dieting;
herbal medicine;
physiotherapy;
the right way of life;
crushing stones with ultrasound;
removal of stones.

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

Medications are prescribed depending on the composition of the stones:

Citrate suppositories, diuretics and vitamins (if the stones are of oxalate etiology);
Diuretic, anti-inflammatory and diphosphonates (if the stones found have a phosphate etiology). With this course of ICD, many doctors recommend home treatment herbs as adjuvant therapy;
Medicines that slow down the process of urea synthesis. Also, drugs are 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:

Pain medication. Medication 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.
Medications to help pass the stone. Appointment 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 calculus (Papaverine, No-shpa, Diprofen).
Preparations that dissolve the stone. Selection of funds according to the composition of the calculus (“Fitolizin”, “Solimok”, “Urodan” and others, as well as dietary supplements - “Prolit”, “Litovit”).

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

Folk remedies

At home, in the absence of pain, as well as for the prevention of relapse, you can use alternative methods. At phosphate stones the effect is noted with regular drinking of decoctions of wild rose or barberry.

Used and combined herbal preparations, consisting of several herbs with a moderate diuretic, antispasmodic and uroseptic effect.

Combine the ingredients in the indicated quantities: garden parsley herb - 20 g, common bearberry leaves, common juniper fruits, field harrow root, medicinal dandelion root - 15 g each; common anise fruits, shepherd's purse herb - 10 g each. Pour 10 g of raw materials in an enamel bowl with 1 glass of boiling water, close the lid and heat in a water bath for 30 minutes, leave for 10 minutes, strain, squeeze the thick. Bring the volume of the broth boiled water up to 200 ml. Take 1/2-1/3 cup warm 2-3 times a day.
Tricolor violet grass - 30 g, horsetail grass - 30 g, St. 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 with phosphate and carbonate stones.
This method of removing stones consists in taking two decoctions. The first decoction is prepared from the roots of wild rose. They need to be ground with a coffee grinder to end up with 50 g of dry powder. Then pour the powder into 700 ml of water and let it boil over the fire for 15 minutes. After that, prepare an infusion of bearberry. To do this, pour boiling water (300 ml) dried or fresh grass (about 30 g), leave for about 2 hours. Take the first remedy three times a day after meals, 300 ml. 25 minutes after its use, you should take a bearberry infusion of 100 ml.
Mix the ingredients in the indicated proportions: large celandine grass - 30 g, common oregano grass - 20 g, common barberry bark - 20 g; pour a tablespoon of the mixture with a glass of boiling water, leave for 30 minutes and take a glass 3 times a day with uric acid stones.
Mix the ingredients in the indicated proportions: nettle leaf and roots - 50 g, licorice root - 30 g; pour a tablespoon of the mixture with a glass of boiling water, insist until cool, strain and drink in 3 doses during the day with nephrolithiasis with jade.
The dissolution of sand and stones in the urinary organs is facilitated by fresh onions and garlic, strawberries, a decoction of melon seed 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) wild rose, fruits of mountain ash, dandelion roots, common calamus rhizomes, corn stigmas, horsetail grass (contraindicated in nephritis). Recommended pumpkin, cabbage pickle and juice, barberry, wild strawberry, wild rose.

recipe list traditional medicine big. It is worth remembering the contraindications of some herbs, therefore, when choosing a method of treatment with folk remedies, a doctor's consultation is required.

Surgical methods

Large urinary stones that are not amenable to dissolution are broken into small fragments, which are either passed out on their own or removed surgically. Stones are destroyed by lithotripsy, acting on them with a shock wave.

There are several types of lithotripsy:

Contact lithotripsy - an endoscopic apparatus 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 - in this technique, a lithotripter is inserted into the kidney through an incision in the lumbar region. It is used for crushing giant and coral-like stones.
ESWL - external shock wave lithotripsy - a non-invasive method in which the impact on the kidney stone is carried out without any skin incisions and other invasive techniques.

In the event that the stone cannot be crushed, a surgical operation 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 - the calculus is removed from the kidney through a small incision in the renal pelvis.
Ureterolithotripsy is an operation to remove a stone from the ureter.

Nutrition rules

Diet and nutrition for urolithiasis depends on the pH and composition of the calculi. Depending on them, doctors have compiled a list of products, the use of which is contraindicated in one case or another.

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

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

In the presence of phosphate stones, you can not use:

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

In the presence of oxalant stones, the following should be avoided:

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

Compliance 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 aggravate the situation.
Systematic eating. Ideally, you should eat at about the same time. It is not recommended to skip meals, this can lead to increased stone formation and deterioration of well-being.
Do not eat excessively high-calorie foods. The energy value of products should correspond to the energy costs that take place in reality.
The diet should be enriched with foods rich in vitamins and amino acids.
Drink about 2-3 liters of normal still water per day. This will increase the amount of urine produced.

Prevention

With the diagnosis of "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 diseases associated with metabolism should pay attention to their health.

Prevention of urolithiasis consists of observing the following recommendations:

Consume clean water. In some regions, the water contains a large amount of salts, which leads to an increase in their concentration in the urine and the formation of crystals. It is better to buy bottled water or use filters with a high degree of purification.
Observe the drinking regime. If there are no contraindications, a person should drink about 2 liters of fluid per day. The best option- it's pure drinking water. It is an ideal solvent and helps to dilute salts and prevent crystals and stones from forming. People living in a hot climate need to increase the volume to 3 liters.
Eat in a balanced way. Kidney stones form in both meat lovers who follow a protein diet and 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. Also, 300-400 g of vegetables and the same amount of fruit in any form are required daily. Groats and bread in total should be 300-400 g.
Don't get dehydrated. infectious diseases, burns, hot weather, prolonged exercise and sports cause significant fluid loss. You must constantly replenish its reserves. To do this, it is advisable to drink often (every half an hour), you can drink 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 urogenital organs and the functioning of the kidneys, and also leads to disruption of metabolic processes. Therefore, it is recommended to drink vitamin complexes 2 times per year.
Don't oversalt food. For an adult, the daily salt intake is 5 g or one teaspoon. This amount includes all the salt in the dishes that you cook and in the products (mayonnaise, herring, chips). Excess salt makes it difficult for the kidneys to work.
visit fresh air. The lack of ultraviolet radiation is bad for the condition of the bones. 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, seek qualified help rather than self-medicate.
Lead active image life. Lack of physical activity contributes to stagnation of urine. And exercises aimed at strengthening the abdominal muscles and lumbar improve kidney function and eliminate congestion. should be 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. Suitable watermelon, pomegranate juice, concentrated decoction of dried apricots (100 g per 0.5 l of water). Some medicinal herbs have a diuretic and anti-inflammatory effect: bear ears, corn silk, horsetail and bearberry. They “wash” the kidneys, prevent the salts from precipitating, and remove the already formed small stones and sand.
Take care of your digestive health. Deficiency of digestive enzymes in diseases of the gastrointestinal tract leads to the formation of calcium oxalate stones. So, ascorbic acid, in case of indigestion, turns into oxalate, which is deposited in the kidneys in the form of crystals.
Avoid hypothermia. Keep your legs 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 muscles 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 of a hereditary nature, 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, ranging from the renal parenchyma, in the ureters, in the bladder to 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) is named after the Russian diplomat and naturalist G. H. von Struve (1772-1851). Previously, these stones were called guanites, because they were often found on bats.

Calcium oxalate dihydrate (oxalate) stones are often referred to as weddelites because the same stones are found in rock samples taken from the bottom of the Weddell Sea in Antarctica.

The prevalence of urolithiasis

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

In the CIS countries, there are areas where this disease occurs especially often:

Ural;
the 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 of France;
South of Spain;
Italy;
Southern regions of Germany and Austria;
Hungary;
Throughout Southeast 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 the nursery 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 are single and 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 urolithiasis. Urolithiasis is a multifactorial disease, has complex diverse mechanisms of development 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 basis of the formation of urinary stones are 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 the acidity of urine.

In the occurrence of these metabolic shifts, some authors prefer the effects external environment(exogenous factors), others - endogenous causes, although their interaction is often observed.

Exogenous causes of urolithiasis:

climate;
geological structure of the soil;
chemical composition of water and flora;
food and drinking regimen;
living conditions (monotonous, sedentary lifestyle and recreation);
working conditions (harmful production, hot shops, heavy physical work and etc.).

The food and drinking regimes of the population - the total calorie content of food, the abuse of animal protein, salt, products containing in large numbers calcium, oxalic and ascorbic acids, lack of vitamins A and group 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, salpingo-oophoritis);
metabolic diseases (gout, hyperparathyroidism);
deficiency, absence or hyperactivity of a number of enzymes;
severe injuries or diseases associated with prolonged immobilization of the patient;
diseases of the digestive tract, liver and biliary tract;
hereditary predisposition to urolithiasis.

A certain role in the genesis of urolithiasis is played by such factors as gender and age: men get sick 3 times more often than women.

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

Symptoms of urolithiasis

Most characteristic symptoms urolithiasis are:

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

Large pelvic stones and staghorn kidney stones are inactive and cause dull pain, more often permanent, in the lumbar region. For urolithiasis, pain is associated with movement, shaking, driving, and heavy physical exertion.

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

renal colic - paroxysmal pain caused by a stone, occurs suddenly after driving, shaking, drinking plenty of fluids, alcohol. Patients constantly change position, do not find a place for themselves, often groan and even scream. This characteristic behavior of the patient often makes it possible to establish a diagnosis "at a distance". Pain sometimes lasts for several hours and even days, periodically subsiding. The cause of renal colic is a sudden obstruction 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, leukocytosis.
nausea, vomiting, bloating, abdominal muscle tension, hematuria, pyuria, dysuria- symptoms often associated with renal colic.
independent stone passage
rarely - obstructive anuria(with a single kidney and bilateral ureteral stones)

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

Stones of the renal calyx

Calyx stones can be the cause of obstruction and renal colic.

With small stones, pain usually occurs intermittently at the time of transient obstruction. The pain is dull in nature, of varying intensity, and is felt deep in the lower back. It may intensify after plentiful drink. In addition to obstruction, the cause of pain may be inflammation of the renal calyx due to infection or the accumulation of tiny crystals of calcium salts.

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

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

Stones of the renal pelvis

Stones of the renal pelvis with a diameter of more than 10 mm. usually cause obstruction of the ureteropelvic segment. In this case, there is severe pain in the costovertebral angle below the XII rib. The nature of the pain is different from dull to excruciatingly acute, its intensity is usually constant. The pain often radiates to the side of the abdomen and hypochondrium. It is often accompanied by nausea and vomiting.

Coral-like stone that occupies the entire renal pelvis or part of it, does not always cause urinary tract obstruction. Clinical manifestations are often poor. Only mild back pain is possible. In this regard, staghorn stones are a finding when examining recurrent urinary tract infections. Left untreated, they can lead to serious complications.

Upper and middle ureteral stones

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

If the stone moves along the ureter, periodically causing obstruction, the pain is intermittent, but more intense.

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

At the 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.

Stones in the lower ureter

Pain with 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 ureter (at the level of the entrance to the bladder) along clinical manifestations recalls acute cystitis, acute urethritis or acute prostatitis, since it can cause pain in the suprapubic region, frequent, painful and difficult urination, imperative urges, 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, genitals. Pain occurs when moving and when urinating.

Another manifestation of bladder stones is frequent urination. Sharp causeless urges appear when walking, shaking, physical activity. During urination, the so-called "stuffing" symptom may be noted - suddenly the urine stream 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 stones, 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 like acute appendicitis, uterine and ectopic pregnancy, cholelithiasis, peptic ulcer and others, which sometimes needs to be done together with doctors of other specialties. Based on this, determining the diagnosis of KSD can be both difficult and lengthy, and includes the following procedures:

1. Examination by a urologist clarification of a detailed anamnesis in order to maximize the understanding of the etiopathogenesis of the disease and the correction of metabolic and other disorders for the prevention of the disease and metaphylaxis of relapses. Important points this stage are clarification:

type of activity;
time of onset and nature of the course of urolithiasis;
previous treatment;
family history;
food style;
a history of Crohn's disease, bowel surgery, or metabolic disorders;
drug history;
the 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;
history of trauma and immobilization.

2. Stone visualization:

performance of 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, performed calcium stress test(differential diagnosis of hypercalciuria) and ammonium chloride (diagnosis of renal tubular acidosis), study of parathyroid hormone.
6. Stone analysis(if available).
7. Biochemical and radioisotope renal function tests.
8. Retrograde ureteropyelography, ureteropyeloscopy, pneumopyelography.
9. Examination 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 have not been fully elucidated, the removal of a stone from the kidney operational way does not mean that the patient is cured.

Treatment of persons suffering from urolithiasis can be both conservative and operative.

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

After establishing the diagnosis, determining the size of the calculus, its localization, assessing the state of urinary tract patency and kidney function, as well as taking into account concomitant diseases and previous treatment, you can proceed to the choice best method treatment to rid the patient of an existing stone.

Calculus elimination methods:

various conservative methods treatment that promotes the passage of a stone with 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 descending into the ureter;
percutaneous removal of kidney stones by extraction (litholapoxia) or contact lithotripsy;
ureterolitholapoxia, contact ureterolithotripsy;
remote lithotripsy (DLT);

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 external lithotripsy (ESL), the creation of high-quality endoscopic equipment and equipment were revolutionary events in urology at the end of the 20th century. It was thanks to these epoch-making events that the beginning of minimally invasive and less traumatic urology was laid, which today is developing with great success in all areas of medicine and has reached its peak associated with the creation and widespread introduction of robotics and telecommunication systems.

The emerging minimally invasive and less traumatic 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 must and can be rid of it! And this is correct, since even small, asymptomatic stones located in the cups must be eliminated, since there is always a risk of their growth and the development of chronic pyelonephritis.

Currently, for the treatment of urolithiasis, the most widely used is extracorporeal lithotripsy (ESL), percutaneous nephrolithotripsy (-lapaxia) (PNL), ureterorenoscopy (URS), due to which the number of open operations is 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, salt, products containing large amounts of calcium into the body, purine bases, oxalic acid;
The consumption of foods rich in fiber has a positive effect on the state of 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 the use of physiotherapy in patients with urolithiasis complicated by urinary tract infection, it is necessary to take into account the phases of the inflammatory process (shown in the latent course and in remission).

Sanatorium-resort treatment for urolithiasis

Sanatorium-resort treatment is indicated for urolithiasis both in the period of the absence of a stone (after its removal or independent discharge), and in the presence of a calculus. 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 independent discharge under the influence of the diuretic action 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).

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

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

Reception of the above mineral waters, as well as mineral water "Tib-2" (North Ossetia) for therapeutic and prophylactic purposes is possible in an amount of not more than 0.5 l / day under strict laboratory control of indicators of the exchange of stone-forming substances.

Treatment of uric acid stones

dissolution of stones (litholysis).

In the treatment of uric acid stones, the following drugs are used:

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

Treatment of calcium oxalate stones

At drug treatment urolithiasis doctor sets himself the following goals:

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

With urolithiasis, stepwise treatment is possible: if diet therapy is ineffective, it is necessary to additionally prescribe medications.

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

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

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

Treatment of calcium phosphate stones

With the medical treatment of urolithiasis, the doctor sets himself the following goals:

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

With urolithiasis, stepwise treatment is possible: if diet therapy is ineffective, it is necessary to additionally prescribe medications.

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

In the treatment of calcium phosphate stones, the following drugs are used:

Antibacterial treatment - if there is an infection;
Magnesium oxide or asparaginate - up to 1 month;
Hypothiazid - up to 1 month;
Phytopreparations (plant extracts) - up to 1 month;
Boric acid - up to 1 month;
Methionine - up to 1 month.

Treatment of cystine stones

With the medical treatment of urolithiasis, the doctor sets himself the following goals:

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

With urolithiasis, stepwise treatment is possible: if diet therapy is ineffective, it is necessary to additionally prescribe medications.

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

In the treatment of cystine stones, the following drugs are used:

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

Complications of urolithiasis

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

by the most frequent complications urolithiasis are:

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

Prevention of urolithiasis

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

Without prophylaxis for 5 years, half of the patients who got rid of stones with one of the methods of treatment, urinary stones form again. It is best to start patient education and proper prevention immediately after spontaneous discharge or surgical removal stone.

Lifestyle:

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

Increasing fluid intake:

It is shown to all patients with urolithiasis. In patients with urine density less than 1.015 g/l. stones are formed much less frequently. Active diuresis promotes the discharge of small fragments and sand. Optimal diuresis is considered in the presence of 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.

The use of fiber.

Indications: Calcium oxalate stones.
You should eat vegetables, fruits, avoiding those that are rich in oxalate.

Oxalate retention.

Low dietary calcium levels 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 (urine oxalate concentration more than 0.45 mmol/day).
Reducing oxalate intake may be beneficial in patients with hyperoxaluria, but in these patients, oxalate retention should be combined with other treatments.
Limiting the intake of oxalate-rich foods for 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 up to 4 g per day may occur without the risk of stone formation. More high doses promote endogenous metabolism ascorbic acid into oxalic acid. This increases the excretion of oxalic acid by the kidneys.

Reduced protein intake:

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

Thiazides:

The indication for the appointment of 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 reduce bone reabsorption. In addition to this, they increase the excretion of pyrophosphate and citrate, which increases the inhibitory activity of urine. Indications: hypercalciuria.
Complications:

diarrhea;
cramps in the abdomen;
nausea and vomiting.

Orthophosphates can be used as an alternative to thiazides. Used for treatment in selected cases, but cannot be recommended as a first line remedy. They should not be prescribed for stones associated with 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 the 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;

You can not use magnesium salts without the use of citrate.

Glycosaminoglycans:

The mechanism of action is calcium oxalate crystal growth inhibitors.
Indications: calcium oxalate stones.