home Audience 2 Urolithiasis: features of the disease in women and methods of its treatment. Treatment of urolithiasis Urolithiasis treatment

Urolithiasis: features of the disease in women and methods of its treatment. Treatment of urolithiasis Urolithiasis treatment

In medicine, urolithiasis is usually called urolithiasis and abbreviated as ICD. It is characterized by the presence of one or more stones (calculi) in one of the parts of the urinary system - the kidneys, ureter or bladder.

This disease, in addition to a possible severe course, can have negative complications including the development of renal failure.

Urolithiasis in women is diagnosed much less often than in men, but despite these statistics, a considerable number of women of all ages suffer from it.

Typically, urolithiasis is characterized by the presence of formations in one kidney or on one side of the ureter or bladder. And only in 15% of cases are stones present in both kidneys or on both sides of these parts of the urinary system. Almost all patients have a certain type of stones – coral stones.

Causes of urolithiasis

The mechanism of development of the disease in each woman is individual and complex. It is almost impossible to identify any specific cause of urolithiasis. However, doctors have named several external and internal factors that contribute to the appearance of insoluble compounds in the urinary system, which subsequently undergo changes - transform into stones.

That is why, if you suspect the presence of urolithiasis and to prevent its further development, it is necessary to undergo a series of studies, including a urine test.

Exogenous (external) predisposing factors

Maintaining a sedentary lifestyle.
Taking certain medications that are prescribed for the treatment of diseases such as HIV, malignant neoplasms, pyelonephritis.
Sedentary work.
Wrong diet.
Constant consumption of drinking water with a certain chemical composition.
Ecology and climatic conditions of the region of residence.

Endogenous (internal) predisposing factors

The presence of certain diseases that provoke an increase in the level of urea, oxalates, calcium and cystine in the body, as well as changes in blood pH. Such pathologies include, for example, gout, tumor neoplasms, and cirrhosis of the liver.
Disruption of the digestive system of organs.
Functional hormonal imbalances.
The presence of congenital pathologies.
Immune system dysfunction.
Genetic predisposition.
Changes in urine acidity levels.
Endocrine diseases.
The presence of acute or chronic infection in the urinary system.

Competent specialists have reason to assert that with the simultaneous impact of several of these factors on a woman’s body, there is a high probability of developing urolithiasis.

Classification of stones

Depending on their composition, stones are divided into 4 classes.

Substances that make up stones	Reasons for education
1. Cystine	Hereditary factor (extremely rare type)
2. Urea	Persistent excess of urea concentration in urine and/or blood
3. Ammonia, magnesium	Infection in urine
4. Calcium, phosphates, oxalates	Excessive levels of these substances in the blood and urine

When making a diagnosis, in addition to research results, the symptoms of urolithiasis in women are of great importance, since they depend on the location of the stones, their structure, quantitative indicator, shape and size. Below are the main symptoms indicating the occurrence of urolithiasis.

1. Deterioration in general health

This is a fairly common manifestation, which can indicate both the development of pathological processes in the body and minor disorders accompanied by reversible processes (for example, fatigue, lack of sleep).

This painful condition begins with chills, which does not stop for a long time. Most often, this indicates not only the occurrence of pathology, but also the development of pyelonephritis.

If urolithiasis is suspected, it is recommended to take a urine test first. If leukocytes are found in its composition, the disappointing diagnosis will most likely be confirmed.

2. The appearance of blood in the urine

This symptom of urolithiasis is medically called hematuria. In some cases, the amount of blood in the urine is so small that its presence can only be detected by microscopic examination.

The situation is spectrally opposite if the urine noticeably changes its color. It can acquire a pale pink or rich red tint. This phenomenon is commonly called macrohematuria. The presence of blood in the urine is due to the fact that dense stones with sharp edges damage the walls of the ureter.

3. Pain syndrome

The vast majority of patients suffering from urolithiasis note that the pain occurs periodically and is paroxysmal in nature. As a rule, an attack begins with aching pain, which subsequently intensifies.

4. Unexpected interruption of the urinary stream

This symptom indicates that the stones are most likely localized in the bladder. Urination is difficult and frequent. This symptom may be “faint” or pronounced, since urolithiasis manifests itself differently in women.

Depending on which part of the urinary system the stones are located in, a certain nature and severity of symptoms are observed.

Localization of stones	Characteristic symptoms
Bladder	1. Heaviness in the area of one of the hypochondrium, perineum, lower abdomen, genitals 2. Frequent and difficult urination, which is accompanied by pain 3. Cloudy urine 4. Blood in urine
Ureter	1. Feeling that the bladder does not empty completely 2. Pain in the genital area, thighs and groin 3. Renal colic 4. Acute pain in the abdominal area, which can radiate to the perineum and lower limbs 5. Attacks of nausea and repeated vomiting
Kidneys	1. Dull pain in the upper lumbar region 2. Presence of blood in urine

It is important to know! - Urolithiasis can be asymptomatic and discovered completely by accident, for example, during an examination of any internal organs. Stones can remain in one or several parts of the urinary system for years and not make themselves felt in any way, not provoke the appearance of symptoms or any discomfort.

Diagnosis of urolithiasis

The difficulty of diagnosing ICD lies in the need to differentiate it (separation, determination of differences) from many other pathologies, among which are:

Presence of stones in the gallbladder;
Peptic ulcer in the acute stage;
Violation of the course of pregnancy (both during uterine and ectopic development of the fetus);
Inflammation of the appendix.

Diagnosis of urolithiasis includes:

Examination by a specialist and medical history. The urologist will definitely ask the patient when the first symptoms appeared, what their nature and severity were, whether she was treated for urolithiasis previously, whether there were any disorders of the immune system and a number of other questions;
Biochemical and general clinical blood test;
Laboratory examination of urine. This includes biochemistry, sensitivity to antibacterial drugs, culture, degree of acidity;
Assessment of the condition of the urinary tract;
Kidney research using radioisotope and biochemical techniques;
Ultrasound and CT of all parts of the urinary system;
A study to determine the degree of stone density;
Carrying out urography. It can be carried out by two methods - excretory (a contrast agent is injected) and survey (images of the affected areas are taken).

Treatment of urolithiasis, drugs

A conservative method of treating urolithiasis 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:

Diuretics, anti-inflammatory and diphosphonates (if the detected stones are of phosphate etiology). With this course of ICD, many doctors recommend home treatment with herbs as an auxiliary therapy;
Citrate suppositories, diuretics and vitamins (if stones are of oxalate etiology);
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).

If necessary, relieve pain, for example, with renal colic, you can take antispasmodics and analgesics. To eliminate the infection, the doctor may prescribe antibacterial drugs.

Surgical treatment

This treatment method is required only if the urinary tract is completely blocked by large stones. In particularly advanced situations, when treatment of urolithiasis was “postponed for later” or carried out incorrectly at home, part of the kidney tissue is removed along with the stones.

Common and least traumatic surgical methods for removing stones from the urinary system are endoscopy and laparoscopy.

Another method of removing stones is lithotripsy - it is prescribed if surgery is contraindicated for the patient. Stones are crushed using ultrasonic waves.

The main advantages are the complete absence of blood loss and a short rehabilitation period. Using highly sensitive sensors, the exact location of the stones is determined, which subsequently break up and come out on their own.

Treatment of urolithiasis at home

Effective treatment of urolithiasis in women at home consists of independently taking medications prescribed by a doctor, vitamin and mineral complexes, performing certain physical exercises, following a drinking regime and an appropriate diet.

Most commonly prescribed drugs and medications

Group of drugs	Drug names
Anti-inflammatory	Indomethacin Ibuprofen Acetomenophen Ketorolac
Antibacterial	Cilastatin Gentamicin Amikacin Ceftriaxone Gatifloxacin
Antispasmodics	Drotaverine Mebeverine Scopalamine Otyponium bromide
Analgesics	Voltaren Diclomax
Diuretics	Furosemide Aldactone Veroshpiron
Vitamins	Groups B

It is important to understand!
In order for treatment at home to have the most positive results and proceed without complications, you must strictly adhere to the instructions of your attending physician.

Treatment of urolithiasis with folk remedies

For effective treatment of urolithiasis in women, it is advisable to turn to traditional medicine methods, which should be used as additional therapy. The most effective folk remedies that will help cope with urolithiasis are:

herbs and herbal preparations (tinctures, decoctions);
fruits of medicinal plants;
natural honey;
some root vegetables;
some legumes;
milk.

Below are three effective recipes that will help dissolve stones, provoke their removal and ease the pain associated with the course of these processes.

Recipe No. 1

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.

Recipe No. 2

Place pre-washed and crushed yarrow (50 g) in a glass container; you can use flowers and grass. Pour 250 ml of high-quality vodka into the flower-herbal mixture. Seal the container and place in a cool, dark place for 7 days. At the end of the infusion period, strain the vodka through a fine strainer until only liquid remains. Take the product three times a day, 20 ml after meals.

Recipe No. 3

This method consists of two stages. First, mix a glass of natural honey with 10 g of calamus rhizome, crushed to a powder state. Mixing should occur by melting honey and powder in a water bath for 10 minutes. After this, mix the resulting mixture thoroughly. Don't be surprised, this product will have a very bitter taste.

The second stage is to prepare the infusion. Mix natural honey with black radish juice, then pour vodka over the mixture. There should be 70 ml of each ingredient. Leave the product in a dry, cool and dark place for 3 days.

These folk remedies should not be taken without examination and consultation with a doctor! If the stones are large, such treatment is unacceptable!

Urolithiasis during pregnancy is quite rare. If the disease has no complications and is asymptomatic, it cannot have a negative impact on the development of the fetus and the course of pregnancy.

The situation is completely opposite if urolithiasis is complicated. In this case, consequences such as gestosis, miscarriage or premature onset of labor may occur.

Treatment of urolithiasis in pregnant women is, as a rule, conservative and consists of following a diet that directly depends on the nature of the disorders of mineral metabolism in the body. If the expectant mother suffers from acute pain, she may be prescribed analgesics and antispasmodics.

For the treatment of urolithiasis during pregnancy contraindicated:

take baths;
use heating pads;
apply warm compresses;
self-medicate using folk remedies.

Surgery during pregnancy is performed in extreme cases. Indications for this method of treatment for MBC are the presence of:

anuria, accompanied by blockage of the urinary canals;
septic condition;
pyonephrosis;
calculous pyelonephritis.

Diet for urolithiasis in women

Compliance with a certain diet is an integral part of the therapeutic program, which allows you to stop further formation of stones in the urinary system, as well as suppress the growth of existing stones.

The diet for urolithiasis in women is based on the following principles:

Systematic consumption of food. Ideally, you should eat around the same time. It is not recommended to skip meals, this can lead to increased stone formation and worsening well-being;
Don't overeat. Food that enters the stomach in large volumes will only worsen the situation;
Drink about 2-3 liters of regular still water per day. This will increase the volume of urine excreted;
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.

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 you have phosphate stones, you should not use:

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

If you have oxalate stones, you should avoid using:

Possible complications

If there is no tendency to excrete stones over a long period of time, progressive inhibition of the functions of the urinary system occurs. The most common complications of urolithiasis in women include:

Anemia due to constant blood loss;
. Such a complication may lead to the development of nephrosclerosis;
Pyonephrosis, which is a consequence of pyelonephritis of a purulent-destructive form, which is in the terminal stage of its development. A kidney affected by pyonephrosis consists of many cavities that are filled with urine, toxic agents and purulent exudate;
Acute renal failure. This complication occurs in rare cases when the patient is missing one kidney or has stones in both kidneys;
Disorder of the hematopoietic functions of the kidneys;
Paranephritis, characterized by the presence of carbuncles, pustules or abscesses in the kidney tissue. This leads to development and is an indication for surgery;
Chronic inflammatory processes with foci of localization in the areas where stones are located. In unfavorable situations, for example, when the patient’s body becomes hypothermic or suffers from an acute respiratory infection, the inflammatory process can go into an exacerbation stage.

Prevention of urolithiasis

Don't eat foods that are too high in calories.
Don't overeat.
Eliminate salt from your diet or, if possible, limit your intake of salt.
Do not eat foods high in animal and plant lipids (fats).
Do not expose your body to hypothermia. Particular attention should be paid to the lower back.
Drink more still water. The minimum is 1.5 liters per day.
Balance your diet. Eat foods high in amino acids, vitamins and beneficial microelements.
Eliminate or limit your intake of fried, spicy, and canned foods.

If you experience the slightest discomfort or pain in the abdomen, lower back or lower extremities, immediately contact a urologist. By adhering to preventive measures, you will reduce the risk of developing urolithiasis to a minimum.

What causes urolithiasis?

Urolithiasis disease occurs when changes occur in the normal balance of water, salts, minerals and other substances in the urine. The most common cause of urolithiasis is lack of water. Try to drink enough water so that your urine is light yellow or clear like water (about 8-10 glasses per day). Some people develop kidney stones as a result of another condition, such as gout.

How to diagnose urolithiasis?

Urolithiasis can be detected if you go to the doctor or emergency room with pain in the abdomen or side. The doctor will ask you a few questions about your lifestyle and the pain you are experiencing. He will then perform an examination and refer you for an imaging procedure, such as a CT scan or ultrasound, to look at your kidneys or urinary tract.

Additional tests may be needed if you have more than one stone or if you have a family history of kidney stones. To determine the cause of the disease, your doctor may order a blood test or ask you to collect urine for 24 hours. This will help your doctor determine whether you will develop stones in the future.

Urolithiasis can be painless. In this case, you will know about the stones if the doctor finds them while testing for another disease.

How to treat urolithiasis?

In most cases, the doctor will advise you to take home treatment. Painkillers may be needed. You will have to drink more water and other liquids to avoid dehydration. The doctor may prescribe you medications that will help the stones pass.

If the stone is too large to pass on its own, or if it is stuck in the urinary tract, you will need other treatments. Out of ten cases of urolithiasis, one or two will require additional treatment.

The most common treatment for urolithiasis is extracorporeal shock wave lithotripsy (ESWLT). DEVLT uses a shock wave to break the stone into small pieces. These fragments can be passed out of the body in urine. Sometimes the doctor will remove the stones or place a small plastic tube (stent) in the ureter to keep it from closing while the stones pass.

How to prevent urolithiasis?

If you have had kidney stones before, it is likely that you will get it again. You can try to prevent stones by drinking enough water so that your urine is light yellow or clear like water, about 8 to 10 glasses of water a day. You may have to give up some foods. Your doctor may also prescribe medications to prevent stone formation.

Treatment of urolithiasis

To pass small stones, most people only need to take painkillers and drink enough fluids.

Treatment of urolithiasis for the first time

If the doctor believes that the stone will pass on its own and you can cope with the pain, then he may suggest home treatments:

Using painkillers. Over-the-counter medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) may help relieve your pain. If necessary, the doctor will prescribe a stronger remedy.
Absorbing enough fluid. You will have to drink a lot of water and other liquids to help the stone pass.

The doctor may prescribe medications that will help the body remove the stone.

If you experience unbearable pain, or stones are blocking your urinary tract, or you have an infection, your doctor will suggest lithotripsy or surgery to remove the stone.

Prevention of subsequent diseases

If you have already had urolithiasis, there is a high chance that you will get it again. Almost half of all people who have had stones will develop new stones within 7 years unless action is taken.

You can prevent kidney stones by drinking more fluids and changing your diet. Talk to your doctor or dietitian about whether you need changes. Your doctor may also suggest medications to prevent stone formation if you have risk factors such as a family history of the disease.

What to think about

You need more intensive treatment for urolithiasis if problems continue and you:

Urinary tract infections.
Renal dysfunction.
Weakened immune system.
Transplanted kidney.

Prevention

If you have already had urolithiasis, there is a high chance of getting it again. But you can take a few steps to prevent this:

v Drink more fluids. Try to drink enough water so that your urine is light yellow or clear like water (about 8-10 glasses per day). Gradually increase the amount of liquid, perhaps adding one glass per day, until the amount reaches 8-10. A gradual increase will give the body time to get used to large amounts of fluid. Water is sufficient when your urine is clear or light yellow in color. If it is dark yellow, then you are not drinking enough fluid. If you have kidney, heart or liver disease and your fluid intake is limited, talk to your doctor before increasing your dose.

v Change your diet. This may help depending on what caused the kidney stones. Your doctor may need more tests before deciding whether changing your diet will help prevent stones from recurring.

Medicines

If new stones appear despite increased fluid intake and diet changes, your doctor may prescribe medications to dissolve the stones or prevent new ones from forming.

Home treatment for urolithiasis

Home treatment involves taking more fluids and painkillers - sometimes this is the only thing needed to pass the stone.

Drink liquid

When a stone passes, you need to drink enough water so that your urine is light yellow or as light as water (about 8-10 glasses per day). If you have kidney, heart or liver disease and your fluid intake is limited, talk to your doctor before increasing your dose.

Take painkillers

Over-the-counter medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) may help relieve your pain. NSAIDs include aspirin and ibuprofen (as Motrin and Advil). If necessary, the doctor will prescribe a stronger remedy.

Medicines

Medicines that make it easier to pass stones

Over-the-counter medications such as nonsteroidal anti-inflammatory drugs (NSAIDs) may help relieve your pain when a stone passes.

Your doctor may also prescribe medications to help your body pass the stone. Alpha blockers have proven that they can clear stones from the body faster without severe side effects. Ask your doctor if they are right for you.

Medicines to prevent stone formation

The type of medicines you take depends on the type of stones.

Calcium stones

Calcium stones are the most common type of stone. To prevent their formation you can take:

Thiazides.
Potassium citrate.
Orthophosphate.

Uric acid stones

Only 5-10 out of 100 stones are made up of uric acid, a byproduct that is excreted from the body in urine. To prevent their formation, you can take:

Potassium citrate.
Sodium bicarbonate.
Allopurinol.

Cystine stones

Only a small percentage of stones are made up of a chemical called cystine. Medicines to prevent their formation:

Potassium citrate.
Penicillamine.
Tiopronin.
Captopril.

Mixed stones

Some mixed stones (staghorn stones) are formed due to frequent kidney infections. If you have mixed stones, you will need antibiotics to treat the infection and prevent new stones from forming. Surgery may be required to remove stones. Urease inhibitors can prevent the formation of new stones.

Operation

Surgery is rarely required to treat urolithiasis. Surgery is only needed if the stone is very large, is caused by an infection, is blocking the flow of urine from the kidneys, or is causing other problems such as heavy bleeding.

In percutaneous nephrolithotomy, or nephrolithotripsy, the surgeon makes a small incision in the back. He then inserts an empty tube into the kidney and either removes (lithotomy) or breaks and removes (lithotripsy) the stone. This surgery may be necessary if other methods do not work or if the stone is very large.
In open surgery, the surgeon cuts into the side to get to the kidneys. He then removes the stone.

If the kidney stones were caused by problems with the parathyroid gland, your doctor may recommend removing it (parathyroidectomy). This may prevent further stone formation.

Other treatments

Other treatments for urolithiasis are more common than surgery. You may need one of these methods if you have severe pain, a stone is blocking your urinary tract, or if you have an infection. Possible options:

External shock wave lithotripsy (ESWLT). ESWL uses a shock wave that travels easily through the body, but is strong enough to break the stone into small pieces. This is the most common procedure for treating urolithiasis.
Ureteroscopy. The surgeon inserts a very thin camera (ureteroscope) into the urinary tract to the location of the stone and then uses an instrument to remove or break up and remove the stones. You may need a small hollow tube (urethral stent) that is placed in the ureter, keeps it from closing, and collects urine and stones. This procedure is used to remove stones that have passed from the kidneys to the ureters.

The stone treatment you need will depend on the size of the stone, its position in the urinary tract, and your health.

Causes

Urolithiasis is a consequence of a change in the normal balance of water, salts, minerals and other substances in the urine. How this balance changes determines the type of stones. Most stones are of the calcium type - they form when the level of calcium in the urine changes.

Factors influencing changes in urine balance:

Insufficient amount of water. If you don't drink enough water, salts, minerals and other substances in your urine can combine and form stones. This is the most common cause of urolithiasis.
Other diseases. Many diseases can affect the normal balance and cause the formation of stones. Examples of such diseases include gout and inflammatory bowel diseases such as Crohn's disease.

Most often, urolithiasis occurs in families, where stones are found in several generations of family members.

In rare cases, urolithiasis occurs because the parathyroid glands produce too much hormone, leading to elevated calcium levels and the possible formation of calcium-type stones.

Symptoms

Urolithiasis begins in the kidneys. If stones remain in the kidneys, they usually do not cause pain. If they leave the body through the urinary tract (including the ureters, which connect the kidneys and bladder, or the urethra, which carries urine out of the body), their movement can cause:

No symptoms if the stone is small enough.
Sudden sharp pain that spreads in waves. Urolithiasis can cause pain in the back, side, abdomen, groin or genitals. People who have had stones usually describe it as "the worst pain I've ever experienced."
Nausea and vomiting.
Blood in the urine (hematuria), which can be caused by either kidney stones or stones passing through the ureter.
Frequent and painful urination, which occurs due to stones in the ureters or after the stone has left the bladder and passes through the urethra. Painful urination can also be a result of a urinary tract infection.

Similar symptoms can also occur with appendicitis, hernia, ectopic pregnancy and prostatitis.

What's happening?

Urolithiasis begins with the formation of tiny crystals in the kidneys. When urine leaves the kidneys, it may carry this crystal out, or it may remain in the kidney. If the crystal remains in the kidney, other crystals will eventually attach to it, forming a large stone.

Most stones leave the kidneys and travel through the urinary tract while they are small enough to pass out of the body easily. In this case, no treatment is needed.

Larger stones may become lodged in the ducts that carry urine from the kidneys to the bladder (ureters). This can cause pain and possibly block the flow of urine to the bladder and out of the body. The pain may increase over 15-60 minutes until it becomes unbearable. The pain may subside when the stone no longer blocks the flow of urine, and usually goes away when the stone moves into the bladder. Large stones usually require treatment.

The smaller the stone, the easier it is for it to leave the body on its own. Out of ten cases of urolithiasis, one or two will require additional treatment.
The average time for a stone to pass is 1-3 weeks, and two-thirds of stones that pass on their own pass within four weeks of the first symptoms.
In about half of people who suffer from kidney stones, the disease may return within seven years if preventive measures are not taken.

Urolithiasis can also cause other diseases:

Increased risk of urinary tract infection or worsening of current inflammation.
Kidney damage if stones block the flow of urine from both kidneys (or from one in people with one kidney). For most people with healthy kidneys, kidney stones do not cause serious damage until the urinary tract has been completely blocked for 2 weeks or more.

Kidney stones are especially dangerous for people with one kidney, people with weakened immune systems, and people with a kidney transplant.

Urolithiasis during pregnancy

When urolithiasis occurs during pregnancy, your obstetrician and urologist will decide whether you need treatment. Treatment will depend on the stage of pregnancy.

What increases the risk?

Some risk factors (things that pose a threat) to urolithiasis increase the likelihood of the disease. Some of them can be controlled, while others cannot.

Risk factors that can be controlled:

Risk factors you can control:

Amount of liquid drunk. The most common cause of urolithiasis is lack of water. Try to drink enough water so that your urine is light yellow or clear like water (about 8-10 glasses per day).
Your diet. Diets high in fat, sodium, and oxalate-rich foods such as green vegetables increase the risk of kidney stones. If you think your diet may be a problem, make an appointment with a nutritionist and review your diet.
Overweight. This can cause both insulin resistance and increased calcium in the urine, which increases the risk of urolithiasis.
Medicines. Some medications, such as acetazolamide (Diamox) and indinavir (Crixivan), can cause kidney stones.

Risk factors that cannot be controlled

Risk factors you cannot control:

Gender and age.

Men aged 30-50 years are more likely to suffer from urolithiasis.
Post-menopausal women with low estrogen levels are more likely to get sick. Women with removed ovaries are also susceptible to the disease.

History of illness in the family.
Frequent urinary tract infections.
Other diseases, such as Crohn's disease, hyperparathyroidism or gout.
Bowel surgery or gastric bypass surgery.
Insulin resistance, which can result from diabetes or obesity.

When to see a doctor?

Consult your doctor immediately if you notice possible symptoms of urolithiasis:

Sharp pain in the side, abdomen, groin or genitals. It can intensify in waves.
Blood in urine.
Signs of a urinary tract infection.

Contact your doctor if you have been diagnosed with urolithiasis and you are also concerned about other problems:

Severe nausea or vomiting.
Acute pain in the side near the kidney.

Contact your doctor to find out if you need an examination if:

You have been diagnosed with urolithiasis and require strong pain medication.
The stone came out, even if the pain was not severe, or there was none. Save the stone and find out if it needs to be tested.

Watchful waiting

Watchful waiting is a “policy of waiting.” If you feel better, you do not need medical treatment. If you feel worse, talk to your doctor about what to do next.

If, on the advice of a doctor, you decide to wait for the stone to pass, then it can pass without additional treatment if you:

You can control the pain with medications.
You know how to find and collect loose stones.
You do not see signs of infection, such as fever and chills.
You can drink plenty of liquid.
Do not experience nausea or vomiting.

Who to contact

If you need urgent help for acute pain due to urolithiasis, you can call an ambulance.

Medical personnel who can diagnose and treat urolithiasis:

Family doctor.
Nurse.
Paramedic.

Tests and analyzes

Most often, urolithiasis is diagnosed the first time you go to the doctor or emergency room with severe pain. Your doctor or emergency physician will ask you some questions and perform an examination. After the stone passes, your doctor may order additional testing to see if you will get stones again.

Tests for diagnosing urolithiasis

Your doctor may order one or more of the following tests to diagnose urolithiasis, look at where the stones are located, and determine whether they may be harming your urinary tract.

(sonogram) is best suited for pregnant women.

Tests to determine the type of stone

Determining the type of stone will help with the choice of treatment and measures to prevent the appearance of stones. The tests may include:

Medical history and physical examination.
Analysis of stones. Your doctor may ask you to collect the stones by passing the urine through a fine sieve or fine cloth. He will then determine the type of stone.
A blood chemistry test to measure kidney function, levels of calcium, uric acid, phosphorus, electrolytes and other substances that may cause stones.
Collect urine for 24 hours to measure volume, pH, calcium, uric acid, and other substances that may cause stones. This test can be done at home.

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 among all urological diseases, and the third among urological diseases leading to death.

What it is?

Urolithiasis is a chronic disease that is caused by metabolic disorders and is accompanied by the formation of stones in the kidneys and urinary tract, formed from the constituents of 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 the genitourinary system, which were caused by streptococcus, staphylococcus, E. 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 containing harmful chemical elements;
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, the outflow of urine is often disrupted in the later stages. 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.

Studying stones for their chemical composition is of great importance in treating the disease and prescribing a 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 of the patient in a hospital.

Painful symptoms are accompanied by complaints of a dysuric nature: frequent 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 calculus is localized at different levels of the ureter, the 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 delaying visiting a doctor and seeking medical help at the first signs of illness. A comprehensive differential diagnosis of urolithiasis, which consists of prescribing laboratory and instrumental examination methods, will help to recognize the disease, determine the location of stones, their size, and evaluate the functioning of the organs of the genitourinary system.

Instrumental diagnostics:

Intravenous excretory diagnostics.
X-ray – evaluates the kidneys, ureters and bladder, identifies stones.
CT or MRI of the kidneys is an informative diagnostic method that 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:

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 with herbs as an auxiliary 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 the general condition of a person, relax the muscles and walls of the ureter (kidney), dissolve possible stones and painless removal.

Folk remedies

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

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

The list of traditional medicine recipes is large. 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

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

If you have phosphate stones, you should not use:

If you have oxalate stones, you should avoid using:

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. People who are at risk or have chronic metabolic diseases should pay special attention to their health.

Prevention of urolithiasis consists of following the following recommendations:

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

What is the cause of urolithiasis, what are the first signs and symptoms in adults, as well as what is prescribed as treatment, we will consider further.

What is urolithiasis?

Urolithiasis is a disease characterized by the appearance of hard stone-like formations in the urinary organs (kidneys, ureters, bladder). At their core, urinary stones are crystals formed from salts dissolved in urine.

Stones in urolithiasis can be localized in both the right and left kidney. Bilateral stones are observed in 15-30% of patients. The clinical picture of urolithiasis is determined by the presence or absence of urodynamic disturbances, changes in renal function and an associated infectious process in the urinary tract.

Types of urinary stones:

Urates are stones consisting of uric acid salts, yellow-brown, sometimes brick-colored with a smooth or slightly rough surface, quite dense. Formed when urine is acidic.
Phosphates are stones consisting of salts of phosphoric acid, grayish or white in color, fragile, easily broken, and often combined with infection. Formed in alkaline urine.
Oxalates - consist of calcium salts of oxalic acid, usually dark in color, almost black with a prickly surface, very dense. Formed in alkaline urine.
Cystine, xanthine, and cholesterol stones are rare.
Mixed stones are the most common type of stones.

Causes

This disease is polyetiological, that is, several factors lead to its development. Most often, urolithiasis develops in people aged 20-45 years, and men suffer from it 2.5-3 times more often than women.

Urolithiasis develops, most often, due to metabolic disorders. But here we should take into account the fact that urolithiasis will not develop if there are no predisposing factors for this.

The causes of urolithiasis are the following:

diseases of the kidneys and urinary system;
metabolic disorders and diseases associated with it;
pathological processes of bone tissue;
dehydration of the body;
chronic gastrointestinal diseases;
poor nutrition, excessive consumption of unhealthy foods - spicy, salty, sour, fast food;
acute lack of vitamins and minerals.

Stones due to urolithiasis can form in any part of the urinary tract. Depending on where they are located, the following forms of the disease are distinguished:

Nephrolithiasis – in the kidneys;
Ureterolithiasis – in the ureters;
Cystolithiasis – in the bladder.

Symptoms of urolithiasis

The first signs of urolithiasis are discovered either by chance, during an examination, or with sudden onset of renal colic. Renal colic is a severe pain attack, often the main symptom of urolithiasis, and sometimes the only one, resulting from spasm of the urinary duct, or its obstruction by a stone.

The leading symptoms of urolithiasis, or what patients complain about:

burning and pain above the pubis and in the urethra during urination - are explained by the spontaneous release of small pebbles, the so-called “sand”;
lower back pain associated with a sudden change in body position, sudden shaking, heavy drinking (especially after drinking liquids such as beer and pickles). Pain occurs due to slight displacement of stones;
hyperthermia (high temperature) – indicates a pronounced inflammatory reaction to the stone at the site of its contact with the mucous membranes, as well as the addition of infectious complications;
Renal colic . When the ureter is blocked by a stone, the pressure in the renal pelvis increases sharply. Stretching of the pelvis, in the wall of which there are a large number of pain receptors, causes severe pain. Stones smaller than 0.6 cm in size usually pass on their own. With narrowing of the urinary tract and large stones, the obstruction does not resolve spontaneously and can cause damage and death of the kidney.
Hematuria. In 92% of patients with urolithiasis after renal colic, microhematuria is observed, which occurs as a result of damage to the veins of the fornical plexuses and is detected during laboratory tests.

Moreover, the size of the stone is not always comparable to the severity of the complaints: the largest stones (staghorn stone) may not bother a person for a long time, while a relatively small stone in the ureter leads to renal colic with severe pain.

Clinical manifestations depend primarily on from the location of the stone and the presence or absence of an inflammatory process.

Signs of urolithiasis when localized in different parts

As the pathological process develops, the following signs of urolithiasis may be observed:

unstable blood pressure;
increased body temperature, sometimes up to 40 degrees;
symptoms of renal colic;
frequent urge to urinate, which does not bring relief;
pain in the lumbar region, sometimes on both sides;
blood in urine;
pain when urinating.

Complications

Common complications of urolithiasis:

Chronic inflammation in the area where the calculus is located, expressed by pyelonephritis or cystitis, which, against the background of negative influences (viral diseases, hypothermia), turns into an acute form.
Chronic pyelonephritis, which rapidly progresses to renal failure.
Acute inflammation of the kidneys can be aggravated by paranephritis with the appearance of pustular lesions of the organ tissue. In the future, an abscess and blood poisoning are likely, which is a direct indication for surgical intervention.
Ischuria, or acute urinary retention.
Pyonephrosis is a severe complication of purulent pyelonephritis, characterized by destruction and melting of kidney tissue.
Anemia occurs as a consequence of constant blood loss from hematuria.

Diagnostics

If you suspect urolithiasis, you should first contact a physician who will conduct an initial examination of the patient. If stones are found in the kidneys, the patient will be referred to a nephrologist, if in the bladder - to a urologist. A dietitian is involved in the treatment, and surgery is often required.

Diagnosis of urolithiasis is based on the following data:

Typical patient complaints include periodic lower back pain, attacks of renal colic, and urinary disorders.
General and biochemical tests of urine and blood.
Excretory urography (injection of a contrast agent into the blood, which is excreted unchanged in the urine).
Retrograde pyelography (injection of contrast in the direction opposite to the flow of urine through the urethra). It is performed rarely and according to strict indications.
Special blood tests for the level of parathyroid hormone and calcitonin, calcium and magnesium salts, determination of blood pH.
CT scan.

The choice of treatment will depend on what kind of stones form in the kidneys during urolithiasis. In order to determine the type of stone, it is enough to take tests:

blood test for calcium (ionized and total), phosphorus, magnesium, uric acid;
general urine analysis;
biochemical analysis of 24-hour urine for urates, oxalates, calcium and phosphorus;
spectral analysis of a stone - provides the most accurate information about its composition.

Based on the research results, the doctor will determine which type of salts predominate and what the stone consists of.

Treatment

Both surgical treatment methods and conservative therapy are used. Treatment tactics are determined by the urologist depending on the age and general condition of the patient, the location and size of the stone, the clinical course of urolithiasis, the presence of anatomical or physiological changes and the stage of renal failure.

General principles of treatment of urolithiasis:

Drink plenty of fluids. Whatever the causes of urolithiasis, concentrated urine promotes the formation of new stones or the “growth” of existing ones. In case of nephrolithiasis, at least 2 liters of fluid per day are recommended.
Diet. Depending on the nature of the pH and the prevailing salts, a diet is prescribed that helps dissolve small stones. The diet can either accelerate their dissolution or contribute to their formation and recurrence of urolithiasis even after the stone has passed.
Physical activity. Inactivity and a sedentary lifestyle provoke the formation of stones, and walking, running, and jumping lead to the removal of microliths.
Herbal medicine: diuretic, anti-inflammatory herbs.
Stone removal (surgical and conservative methods).

Medicines for urolithiasis:

Anti-inflammatory: indomethacin, ibuprofen, acetomenophen, ketorolac;
Antibacterial: cilastatin, gentamicin, amikacin, ceftriaxone, gatifloxacin;
Antispasmodics: drotaverine, mebeverine, otiponia bromide;
Analgesics: voltaren, revodin, diclomax;
Diuretics: furosemide, aldactone, veroshpiron
Vitamins: group B.

Operation

Indications for surgery for urolithiasis:

large stones, when they cannot be crushed and removed without surgery;
significant impairment of renal function, despite the fact that other treatment methods are contraindicated in this case;
position of the stone: if it is located inside the kidney, then it is very difficult to crush it and remove it;
complication in the form of a purulent process in the kidneys (purulent pyelonephritis).

Types of surgical intervention:

Endoscopic removal of stones from the bladder and terminal ureter.
Laparoscopic surgery on the kidney or ureter.
Extended open kidney surgery (performed in the presence of a large one, when its resection or removal is required).
Lithotripsy. Destruction of stone by a focused electro-hydraulic wave. The destroyed calculus is excreted in the urine in the form of sand.

Diet

Depending on the type of urinary formations and identified metabolic disorders, the doctor prescribes nutrition for urolithiasis. In general, the diet for urolithiasis includes:

increasing fluid intake (at least 2 liters per day);
reducing the volume of portions;
an increase in fiber-rich foods in the diet;
limiting the intake of salt and spices;
limiting the consumption of foods and drinks with stone-forming properties (animal protein, purines, oxalic acid, etc.).

What should you not eat if you have different types of urolithiasis?

Nutrition for kidney stones will depend on the composition of the stones, and therefore may include mutually exclusive foods. Calcium is the basis of most urinary stones. The greatest prevalence of calcium stones (including calcium oxalate and calcium phosphate), urate, consisting of uric acid salts and magnesium-containing stones is noted. The main role in the formation of calcium oxalate is played by supersaturation of urine with calcium and oxalate.

Therapeutic diet with the deposition of oxalate stones provides exclusion from food:

green salad, spinach, sorrel, rhubarb, beets, celery, parsley;
chocolate, cocoa;
jelly and jellies;
figs and purslane;
vitamin C in the form of a food supplement, as well as products where the vitamin is a preservative;
smoked meats, saltiness and marinades;
broths and spices;
offal.

Prohibited Products with the deposition of urate stones:

canned food, marinades;
fish and meat of adult animals (you can eat boiled non-fat varieties three times a week), veal and lamb are excluded;
sausages and various smoked meats;
offal (brains, liver, lungs);
salted cheese;
animal fats (pork, beef or cooking);
fish;
jellies;
sorrel and spinach, cauliflower, rhubarb and figs;
rich broths, including mushroom ones;
mushrooms;
legumes;
alcoholic drinks (especially beer and red wine);
tea and coffee (sometimes not strong), cocoa and chocolate, cranberry juice.

For phosphate stones The following are temporarily excluded from the diet:

calcium-rich foods: dairy products, eggs, cocoa;
salty and spicy foods (limit salt to 8 g per day);
garden greens (lettuce, green onions, dill, parsley, celery leaves and cilantro);
potato;
nuts, cocoa;
sweet confectionery (biscuits, pastries, cakes);
fruit juices;
yeast.

Before using any folk remedies, you need to consult your doctor. Because in the presence of large stones, serious consequences are possible.

Basically, various herbal preparations are used, the type of which is selected depending on the chemical composition, size and location of the stones. The composition of medicinal preparations may include the following medicinal plants:

Prevention

Preventive methods of urolithiasis consist of the following recommendations:

sufficient physical activity;
reduction of body weight to optimal levels;
limiting the consumption of alcoholic beverages;
prevention of stressful situations;
expanding the drinking regime to 2.5–3 liters during the day;
limiting the consumption of animal proteins, replacing them with vegetable ones.

If you are diagnosed with urolithiasis, be sure to start treatment only after your doctor’s consent. Self-medication can lead to serious complications for the entire body. Be healthy!

Urolithiasis develops as a result of metabolic disorders and is manifested by the formation of stones in the organs of the urinary system.

The condition when stones form in the kidneys is called nephrolithiasis; in the ureters - ureterolithiasis; in the bladder - cystolithiasis.

Causes

All causes leading to the formation of stones in the urinary system are divided into exogenous (external) and endogenous (internal).

The following can be classified as exogenous:

prolonged drinking of hard water;
living in climatic zones where there is a lack of ultraviolet rays;
large consumption of sour, salty, spicy foods;
not drinking enough water during the day;
sedentary lifestyle.

The endogenous ones include the following:

impaired renal function as a result of chronic diseases;
genetic predisposition to stone formation;
infectious diseases accompanied by dehydration;
severe diseases in which the patient requires long-term immobilization;
pathology of the gastrointestinal tract (due to disruption of the processes of digestion and absorption);
metabolic disorders (hyperparathyroidism, gout);
congenital anomalies of the structure of the kidneys and urinary tract.

Most often with urolithiasis, inflammatory kidney diseases (pyelonephritis, glomerulonephritis), gout, hyperparathyroidism, cholelithiasis, cystitis, prostatitis, pancreatitis, colitis are present.

There are 5 types of stones:

urate, appear in cases of uric acid metabolism disorders (gout);
oxalate, appear with an increased content of oxalate salts;
phosphate, appear due to disturbances in phosphorus metabolism;
cystine, they appear in hereditary pathologies;
mixed, a combination of several types of metabolic disorders.

Symptoms of urolithiasis

In men, this pathology is detected three times more often than in women. The clinical manifestations of urolithiasis are the same in men and women.

The severity of symptoms depends on the size of the stones and where they are located.

In the presence of small stones, the disease is asymptomatic, or after heavy physical activity discomfort may appear in the lumbar region. At this stage, stones are most often diagnosed accidentally during examinations.

Localization of pain in urolithiasis

The most integral symptom is pain.

The pain can be constant or paroxysmal; aching or acute in nature; The severity of pain depends on the size of the stone and its location.

Pain from kidney stones

When stones are found in the kidneys or upper parts of the ureter, pain occurs in the lumbar region and is aching in nature.

However, if a stone causes obstruction (blockage) of the ureter, the outflow of urine is disrupted and the pain increases significantly. The patient develops renal colic. It is characterized by severe pain that does not go away when changing body position. The pain can last from a few minutes to several days. Patients rush about, and there is a frequent urge to urinate.

The pain is most often unilateral, but can rarely be bilateral.

As the stone moves through the urinary tract, the pain decreases.

Pain in the lower abdomen in men can spread to the external genitalia and scrotum. The pain resembles prostatitis, testicular torsion.

In women, pain in the lower abdomen radiates to the labia and vulva.

Urination becomes difficult, it becomes frequent and painful.

Pain from bladder stones

When there are stones in the bladder, the pain is localized in the suprapubic region; with small stones, the pain is aching. Irradiation of pain also into the area of the external genitalia.

Blood in urine and sand

The second most common symptom is hematuria (blood in the urine).

Hematuria occurs when stones move through the urinary tract due to damage to the mucous membranes. When passing small stones, blood can only be detected by examining urine. And when large stones pass, the patient himself may notice a pink coloration of the urine.

The patient may also see small stones (sand) in the urine sediment.

Diagnostics

If signs of urolithiasis are detected, you must consult a urologist or nephrologist and undergo the necessary examination.

General urine analysis:

Allows you to detect hematuria - the appearance of red blood cells in the urine. In the presence of inflammation in the urinary system, an increased number of leukocytes and an increase in urine density are detected. Salts (oxalates, phosphates, urates) are found in urine sediment.
If there are stones in the urine sediment, they are examined. The character of the stone is established.

Biochemical blood test:

Aimed at identifying metabolic disorders. The level of uric acid, phosphates, oxalates, kidney function (creatinine, urea, glomerular filtration rate) are assessed.

General blood analysis.

Anemia (decreased hemoglobin) can be detected with prolonged blood loss; an increase in the number of leukocytes and the erythrocyte sedimentation rate of ESR during the inflammatory process.

Ultrasound examination of the kidneys and bladder.

Allows you to identify the presence of stones and signs of inflammation.

To detect stones in the ureter, clarify their location and the degree of obstruction of the urinary tract, excretory urography is performed. The study is carried out by introducing a radiopaque substance and then assessing its removal rate.

If there is a blockage in the lower urinary tract, retrograde ureteropyelography is performed. The contrast is injected not into the kidneys, but from bottom to top - along the ureters.

Computed tomography may also be prescribed to clarify the diagnosis. It allows you to clarify the size of the stone and its position.

Treatment of urolithiasis

If there are small stones, treatment is carried out on an outpatient basis. Therapy is prescribed by a nephrologist or urologist.

If the stones are large or the patient develops renal colic, then treatment is inpatient. The duration of hospitalization depends on the treatment performed, on average 10-14 days.

Treatment of urolithiasis is aimed at removing stones and correcting metabolic processes to prevent their recurrence.

Methods for removing stones depend on the size of the stone and its location.

Small stones can pass through the urinary tract on their own.

To alleviate the condition and reduce pain, the patient (if renal colic occurs) is prescribed antispasmodics and painkillers.

Drotaverine;
Papaverine;
Duspatalin;
Analgin.

Dissolving stones using medications

If urates are present, the following are used:

Allopurinol;
Etamide;
Ugly.

If phosphate stones are present, the following are prescribed:

Cyston;
Marelin;

For oxalate stones use:

Blémarin;
Spilled;
Pyridoxine.

For cystine stones use:

Penicillamine;
Potassium citrate;
Uralite.

Crushing stones and then removing them

Shock wave lithotripsy.

Using a shock wave, the stone is crushed and then removed through the urinary tract. The method is not suitable for large stones.

Stones are also destroyed using ultrasonic waves and lasers.

Percutaneous nephrolithotomy.

Endoscopic intervention using instruments to break up the stone, followed by removal of parts of the stone from the kidney.

Litholapaxy.

This is an endoscopic removal of stones from the bladder.

Physiotherapeutic treatment is also used for urolithiasis:

diadynamic amplipulse therapy - used to relieve pain;
inductothermy - used as antispasmodic therapy and pain relief;
exposure to sinusoidal currents - used to relieve swelling of the ureteral mucosa and spasms. Used during remission.
Magnetic therapy - used to relieve pain.

Diet

More information about the diet for kidney stones is written in our separate article.

Be sure to drink about two liters of liquid during the day;

For urate stones, it is necessary to limit:

meat; fish;
mushrooms;
legumes;
beer.

For oxalate stones:

chocolate, cocoa;
beets, lettuce, spinach;
foods rich in oxalic acid;

For phosphate stones:

salt;
carbonated drinks;
alcohol;
currants, cranberries;
dairy products.

Prevention of stones

The main direction in the prevention of urolithiasis is the normalization of metabolism.

If metabolic processes are not normalized, then relapse of the disease is inevitable.

giving up alcohol;

maintain normal weight;

drink about 2 liters of liquid per day;

reduce salt intake;

When determining the type of stones, follow dietary recommendations.

promptly treat inflammatory diseases of the urinary organs.

be regularly examined by a urologist or nephrologist.

Complications

If urolithiasis is not treated correctly, the most common complications are:

The development of an inflammatory process in the kidneys, ureter or bladder. This is the most common complication. Caused by stagnation of urine and damage to the mucous membranes.

The inflammatory process can spread to the perinephric tissue (paranephritis). It develops in the absence of treatment of pyelonephritis or inadequate treatment of nephritis.

Due to a long-term inflammatory process (chronic pyelonephritis), chronic renal failure develops.

If the urinary tract is completely blocked on both sides, which is extremely rare, acute renal failure may develop.

With timely diagnosis, proper treatment and subsequent adherence to recommendations for the prevention of the disease, the prognosis is favorable. Compliance with preventive measures will help avoid relapses of stone formation.