home Audience 6 Causes of urolithiasis in women: symptoms and treatment with medicines and folk remedies, a special diet and exercise. Treatment of urolithiasis - all methods

Causes of urolithiasis in women: symptoms and treatment with medicines and folk remedies, a special diet and exercise. Treatment of urolithiasis - all methods

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 disturbances can occur 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 internal organs, but also on some factors environment.

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

Causes of the appearance and development of urolithiasis

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

The main internal factor can be attributed to the disruption of metabolic processes in the human body - fat, mineral or protein metabolism, as a result of which excess substances are formed and precipitate. Exchange processes can be either a consequence of diseases or an independent condition.

Impaired outflow of urine from the kidneys through the ureters into the bladder and then from it into the urethra is an important factor in the development of KSD. With such a violation, a reverse flow of urine against the current or its stagnation in the bladder or kidneys may occur, which leads to the accumulation of 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 gastrointestinal tract, musculoskeletal system, liver and other organs can also cause the development of urolithiasis.

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

External factors influencing the development of urolithiasis:

Excessive content in food table salt;

Lack of fluid;

Abuse of various spices containing salt;

Consumption of large amounts of smoked foods and alcoholic beverages;

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

Chronic pyelonephritis.

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

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

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

Currently, urolithiasis is diagnosed using renal ultrasound, radiography, and general analysis urine.

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

Urolithiasis disease(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 outflow of urine and causes renal colic and inflammation.

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

What is urolithiasis?

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

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

Types of urinary stones:

Urates are stones made of salts. uric acid, yellow-brown, sometimes brick color 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, fragile, easily broken, often combined with infection. Formed in alkaline urine.
Oxalates - consist of calcium salts of oxalic acid, usually dark in color, almost black with a spiky 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 one 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:

kidney and urine diseases excretory 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 severe inflammatory reaction on the stone at the place of its contact with the mucous membranes, as well as on the occurrence 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 urination that 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 is accompanied by negative influences(viral diseases, hypothermia) become acute.
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 about periodic pain in the lower back, attacks of renal colic, urinary disorders.
General and biochemical tests urine and blood.
Excretory urography (introduction into the blood contrast agent, 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

Used as surgical methods treatment and conservative therapy. 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 stages of renal failure.

General principles of treatment of urolithiasis:

Plentiful drink. 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 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);
reduction in portion size;
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 jelly;
figs and purslane;
vitamin C in the form food additives, 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 three times a week not fatty varieties boiled), 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. Part medicinal fees 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;
restriction of use alcoholic drinks;
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 whole organism. Be healthy!

Often patients turn to the doctor with an attack of acute pain in the lumbar region. In 90% of all cases, urolithiasis manifests itself in this way - a fairly common ailment that in recent years has occurred in every sixth person on the planet. People of any age and gender suffer from painful attacks, which makes this pathology extremely dangerous. In order to recognize the first signs of the development of the disease in time and consult a doctor, you need to have certain information about the manifestations of the disease.

What is urolithiasis

Urolithiasis is pathological condition, which is characterized by the formation of salt and protein conglomerates in various parts of the excretory system. In this case, patients experience severe discomfort throughout the entire period of development of the disease.

Urolithiasis is characterized by some seasonality - this pathology is more common in winter and spring, which is associated with a large number of holidays and feasts where people eat junk food and drink alcohol.

Most often, stones form in the kidneys

Pathological formations form in all parts of the excretory system, but the kidneys are more often affected, since the main work of cleansing the blood of harmful impurities takes place there. Damage to the ureter or bladder is much less common.

Stones in the ureters and bladder can enter here from the kidneys with urine flow

What types of stones are there?

Stones formed in the urinary organs may vary in size, shape, and structure.

Classification of pathological formations due to their occurrence:

oxalates and phosphate stones - are formed due to excess calcium;
urate stones - typical with a large amount of uric acid in the body;
mixed formations - characteristic of genetic diseases associated with metabolic disorders.

Types of stones depending on their shape:

oval and round;
with sharp corners;
stellate;
by type of coral.

Classification of stones by size:

small (1–2 mm);
medium (5 mm–1 cm);
large (2–5 cm);
huge (6 cm or more).

Photo gallery: types of pathological formations

Small stones can be removed with conservative therapy Stones with sharp edges can injure the ureter and cause bleeding Coral stone fills the entire kidney

Causes of urolithiasis development

The main factors influencing the formation of the disease are:

poor nutrition;
drinking poor quality water;
unauthorized taking of medications;
drug overdose;
sedentary lifestyle;
hereditary predisposition;
past inflammatory processes in the organs of the urinary system (pyelonephritis, glomerulonephritis, cystitis).

Main clinical symptoms of the disease

This disease in 90% of cases is characterized by a combination of general and local symptoms. The former are caused by the body's reaction to a stressful stimulus - the inflammatory process, and the latter are associated with the damaging effect of the stone on the mucous membrane.

The general symptoms that appear with urolithiasis are as follows:

nausea and vomiting;
dry mouth;
alternating constipation and diarrhea;
loss of appetite;
sudden weight loss;
yellowish color of the skin;
temperature rise to 37–38 degrees;
swelling of the eyelids, cheeks, forehead and chin;
seizures in the corners of the mouth;
height blood pressure up to 220/100 millimeters of mercury.

Local signs:

the presence of palpable formations in the kidney, ureter or bladder;
pain when feeling the lower back, which increases with stress, physical activity or when drinking large amounts of water;
formation of protein, sand, blood and other foreign impurities in urine;
pain when urinating;
false urge to urinate.

Photo gallery: manifestations of pathology

Pain in the lumbar region is one of the symptoms of urolithiasis. Seizures in the corners of the mouth indicate a problem with metabolism. Renal edema, unlike cardiac edema, occurs after sleep.

Features of the course of the disease in children

The body of a baby is significantly different from the body of an adult. This explains the more severe course of the disease in children of all ages. The peak incidence occurs at 7–14 years of age, when the child changes his eating style under the influence of peers. The development of the disease in babies begins acutely, with a rise in body temperature to 39-40 degrees. In children under one year old, spastic twitches of the trunk may occur - febrile convulsions.

The pain is usually localized under the ribs, due to the higher location of the kidneys. When urinating, the formation of blood clots is quite often observed, which practically does not happen in adults.

Methods for diagnosing urolithiasis

Unfortunately, nowadays a combination of several diseases is becoming more and more common. Often they are so cleverly disguised as each other that even an experienced doctor with great experience cannot make a diagnosis without additional examination.

In his practical activity, the author participated in the treatment of a patient who was observed by a neurologist for more than a year with lumbar osteochondrosis and back pain. All the therapy she did helped her only for a short period of time, after which the unpleasant sensations returned again. When the patient was ultrasonography kidneys, the presence of a large coral-shaped stone was revealed, which became the cause of the development of unpleasant sensations. After its removal, the patient felt much better and was able to continue treatment with a neurologist.

Methods for confirming the diagnosis:

How to deal with the disease in the hospital and at home

Immediately after the diagnosis is confirmed, the patient is hospitalized in the nephrology department, where specialists will treat him. At the initial stage of urolithiasis and when the conglomerates are small, there is a chance that they will pass out on their own in urine if the patient eats properly and takes medications. In cases where the disease progresses over several years, doctors consider surgery.

If an exacerbation of urolithiasis catches you in the middle of the working day, do not be scared or panic. Usually the attack can be relieved with a warm bath or a heating pad placed on the lumbar region. If this does not help, it is permissible to use an antispasmodic such as No-shpa or Baralgin.

Two tablets of the drug will help you get rid of discomfort for a while

Drug therapy of pathology

To reduce discomfort in a hospital setting, novocaine blockade is often used. This method of treatment helps to completely relieve the patient from pain, as it prevents the flow of nerve impulses from the site of injury to the brain. Using a long and thin needle, the doctor injects Novocaine solution into the area spermatic cord in men and the broad ligament of the uterus in women, after which it waits for fifteen minutes. If there is no effect from the blockade, the procedure is repeated.

Other groups of drugs used to treat pathology:

Antibiotics. Prevents the growth of harmful microflora and reduces the risk of developing purulent complications. The most commonly used are Augmentin, Ampiox and Ceftriaxone.
Anti-inflammatory drugs. Reduce soft tissue swelling and severity pain syndrome. For this purpose, Nice, Tamoxifen, Ibuklin and Diclofenac are used.
Antispasmodics help relax the muscles of the pelvic organs and are used during an attack of colic. The most famous medications: Pentalgin, Spazgan, Baralgin.

Photo gallery: pharmaceuticals to restore kidney function after illness

Augmentin - antibiotic wide range action that kills most germs
Nise is a non-steroidal anti-inflammatory drug with an analgesic effect. Pentalgin-N is a drug that relieves spasms in 10 minutes.

Traditional treatment of urolithiasis

For the treatment of diseases of the excretory system, various herbs, plants and aromatic oils based on them are widely used. However, do not forget that warming the kidneys can only be carried out in the absence of an inflammatory process: otherwise, this may cause a worsening of the condition.

Folk recipes used for illness:

Take a full bath of hot water, then add ten drops each of sea buckthorn and rosemary oils. Before diving, be sure to apply a small amount to your wrist to test for an allergic reaction. In her absence, spend at least half an hour in the bathroom. Sea buckthorn and rosemary oils have an antispasmodic effect and relieve pain. It is recommended to carry out the procedure once a week.
Simple baking soda can be used for urate stones. Dissolve one teaspoon in a glass of warm water, then drink it half an hour before any meal. This procedure helps reduce the growth of conglomerates and ensures their removal from the body. The course of treatment lasts at least three months.
Boil one hundred grams of rose hips in a liter of boiling water for fifteen minutes. After cooling, drink one glass before breakfast, lunch and dinner. Rosehip has a mild anti-inflammatory effect and helps reduce the discomfort that occurs when urinating. It is necessary to be treated in this way for six months.

Photo gallery: natural remedies for treating illness

Rosemary oil has an antispasmodic effect
Baking soda helps fight urate stones Rosehip is a source of vitamin C and strengthens the immune system

Nutrition and drinking regimen for patients

When preparing a diet for patients with urolithiasis, doctors take into account the nature of the pathological formations and their size. If you have phosphate stones, it is forbidden to consume dairy products, but it is extremely useful to eat meat, fish, various cereals and vegetables. Treatment of urate and mixed stones requires giving up protein foods, but it is necessary to enrich your diet with fruits, cereals and various nuts. The patient should drink at least two liters of clean water daily.

The use of onions is encouraged in any diet. Not only does it contain many vitamins and minerals, but it also helps protect the body from harmful microbes.

Some foods you need to avoid:

seeds and salted nuts;
fast food;
semi-finished products;
sweets;
carbonated drinks and packaged juices.

Photo gallery: junk food for urolithiasis

Seeds are usually fried with salt in vegetable oil, which is not beneficial for the body. Fast food is a source of harmful fats. Sweets contain a large amount of fast carbohydrates, which slow down metabolism.

Video: diet for urolithiasis

Surgical treatment of pathology

If the stones are large and cannot be removed with medication, surgery is necessary. Currently, there are many varieties and various modifications for the removal of pathological stones, but traditionally only a few of them are used in Russian clinics:

Open surgery is performed through a wide incision in the lumbar region. A kidney, ureter or bladder is removed into the wound, after which the stones are removed from them. This technique is used only for massive formations (4 or more centimeters in diameter).
Endoscopic surgery is performed through a small incision in the lumbar region using special instruments. In case of multiple small stones, this surgical solution allows achieving best result. After the intervention, only a small and invisible scar remains.
Ultrasonic crushing of kidney stones using special device- lithotripter. Medium-sized formations can be removed by similar procedure. Under the influence of a sound wave, they split into sand and are easily and painlessly removed with urine.

Photo gallery: operations used for illness

Crushing stones with ultrasound is a completely painless procedure. After endoscopic surgery, completely invisible scars remain. During open surgery, it is often necessary to remove part of the kidney.

Therapeutic exercises for urolithiasis

To normalize blood flow in the area where the pelvic organs are located, it is necessary to engage in physical activity daily. Exercise not only helps strengthen the body, but also stimulates regeneration processes, so that damaged tissues are restored more actively. Here are a few exercises that are recommended for urolithiasis:

Lie on your back on a gymnastics mat. Stretch your legs and arms forward as much as possible as you inhale, and while exhaling, press them to your chest, forming a kind of ball. It is believed that such an exercise helps to stretch the muscles and prepare them for subsequent loads. The recommended number of repetitions is at least five.
Lying on your back, raise your knees bent and hip joints legs. Simulate riding a bicycle for two to three minutes. This exercise provides blood flow to the organs of the urinary system and helps to strengthen the abdominal muscles.
Stand with your feet shoulder-width apart and make uniform inclinations, trying to touch your fingertips as much as possible. The knees should be straight. The recommended number of approaches is three seven times.

Video: exercises to help get rid of the disease

What consequences await patients with a similar disease?

Unfortunately, the formation of stones in the urinary system does not go unnoticed by the body. Often, the course of the pathology is complicated by the addition of other ailments, which also affect the patient's health. Urolithiasis is prone to recurrence even in conditions of complete psychological and physiological calmness, about which doctors immediately warn the victims.

In the presence of constantly recurring attacks of renal colic (at least five times a year) and massive staghorn formations, the patient is prohibited from serving in the army. In all other cases, the issue is resolved individually for each patient.

Lifestyle also affects the state of the body after suffering an illness. In his practice, the author encountered a patient who had rather large formations in both kidneys. They caused the victim severe discomfort and periodically parts of them came out in the form of sand and urine. After the prescribed treatment, the patient was discharged home for a course of physiotherapy at the place of residence. In 90% of cases, stones of this size would have to be operated on sooner or later. However, this patient, by regularly taking medications and following a special diet, achieved an almost impossible effect: pathological formations were completely eliminated from the body in urine within a year and a half.

What complications may occur in patients with a similar disease:

Exacerbation of urolithiasis - pathological process, which is usually accompanied by stone passage and intense pain. Unpleasant sensations can haunt the patient for several hours and even days, which greatly complicates the usual rhythm of life. Treatment of exacerbation is carried out only by a doctor in a specialized medical institution.
Development of pathological expansion pelvicalyceal system- pyeloectasia. When the outflow from one part of the urinary tract is disrupted, a large amount of fluid accumulates in another, which causes its stretching. The walls of organs become thinner and more easily permeable to bacteria, which creates a risk of developing a secondary infection. Conservative therapy There is no such complication: patients will need to undergo a special operation for pelvic plastic surgery.
Formation of purulent-septic shock. When an area of the kidney or ureter is compressed for a long time by a stone in the area of the bedsore, bacteria begin to multiply, enter the bloodstream and spread throughout the patient’s body. They can settle in the gates of the liver, blood vessels and even in the heart muscle. Generalization of the process often ends in blood poisoning, which is treated only in the intensive care unit with the help of infusion therapy.

Photo gallery: complications of pathology

The formation of an attack of renal colic is based on an exacerbation of urolithiasis due to migration of the stone. With the development of purulent-necrotic complications, the affected organ must be removed. Hydronephrosis is the accumulation of fluid in the renal pelvis, which is the cause of the development of pyelectasia

Rehabilitation after urolithiasis

Various physiotherapeutic procedures are actively used to restore kidney function. They also help reduce residual symptoms of urolithiasis and allow the patient to quickly return to their normal rhythm of life. The number of procedures, the order of their implementation and duration are determined by the attending physician.

The most noticeable results are obtained by the following procedures:

Baths with hydrogen sulfide. The patient is completely immersed in the warm water with medicinal gas. Hydrogen sulfide improves the removal of toxic substances from the body, preventing their accumulation in soft tissues.
Inductothermy is the use of magnetic fields of varying power and intensity to influence areas of the urinary system. This procedure helps relieve pain and reduce the severity of spasm of smooth and striated muscles.
Medicinal electrophoresis with various drugs - use electric current to introduce the required amount of medication into the body. With such implementation pharmaceuticals their optimal concentration is created in the lumbar region, which allows you to quickly remove the symptoms of the disease.

Photo gallery: the use of physiotherapy for illness

Reception hydrogen sulfide baths is carried out only under the supervision of a physician. The use of inductothermy allows one to achieve excellent results in the restoration of the kidneys. Electrophoresis helps to quickly introduce the drug into the body.

Lifestyle changes in pathology

Urolithiasis leaves a serious imprint on the patient’s life. Since the body becomes especially vulnerable to the effects harmful factors environment, doctors recommend taking care of your health and being more attentive to even simple habits. What you should give up during treatment and rehabilitation:

There are some misconceptions among patients regarding actions that are prohibited. Often, most of them, subject to proper restrictions, are completely harmless and do not in any way affect the course of urolithiasis:

How to protect yourself from the development of pathology

Over the past few years, there has been an increase in the incidence of this disease tenfold. This is largely due to changes in the lifestyle of the population, the transition to semi-finished products and fast food, the quality of drinking water, as well as many other features. To reduce the number of victims of urolithiasis, doctors and scientists are developing entire sets of measures dedicated to improving the health of citizens. Don’t forget about the rules for individual prevention of urolithiasis: no one knows your body better than you yourself.

The author of the article, together with his colleagues and scientific supervisors, annually participates in lectures and seminars on kidney diseases. Urolithiasis has a special place among all of them. To develop methods for individual prevention, students regularly survey the population regarding lifestyle, health status, nutrition and motor activity. Anyone can also attend an open seminar and receive detailed consultation from a doctor on a problem of interest. As it was found out after analyzing the data, about 70% of people who came to this event experienced an attack of renal colic at least once in their lives. Just under half of them went to a doctor, while the other part of the population preferred to be treated at home. About 10% have already been diagnosed with urolithiasis and try to adhere to a certain type of diet, while the rest of the people have never had their urine tested. All patients were asked to undergo an ultrasound examination of the kidneys, after which they received the necessary recommendations for a further course of therapy.

Based on data regarding the lifestyle of patients, following rules prevention of urolithiasis:

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

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

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

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

Prevalence of urolithiasis

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

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

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

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

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

In Europe, urolithiasis is widespread in:

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

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

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

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

Causes of urolithiasis

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

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

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

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

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

Exogenous causes of urolithiasis:

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

The food and drinking regimes of the population - the total calorie content of food, abuse of animal protein, salt, foods containing large amounts of 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, both in the urinary tract and outside urinary system(tonsillitis, furunculosis, osteomyelitis, salpingo-oophoritis);
metabolic diseases (gout, hyperparathyroidism);
deficiency, absence or hyperactivity of a number of enzymes;
severe injuries or illnesses associated with prolonged immobilization of the patient;
diseases of the digestive tract, liver and biliary tract;
hereditary predisposition to urolithiasis.

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

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

Symptoms of urolithiasis

Most characteristic symptoms urolithiasis are:

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

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

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

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

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

Kidney calyx stones

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

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

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

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

Renal pelvis stones

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

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

Stones of the upper and middle part of the ureter

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

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

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

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

Lower ureteral stones

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

A stone located in the intramural portion of the ureter (at the level of the entrance to the bladder) at clinical manifestations reminds acute cystitis, acute urethritis or acute prostatitis, since it may cause pain in 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 and genitals. Pain occurs when moving and urinating.

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

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

Signs of urolithiasis

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

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

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

2. Visualization of the stone:

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, carried out calcium stress tests(differential diagnosis of hypercalciuria) and ammonium chloride (diagnosis of renal tubular acidosis), parathyroid hormone test.
6. Stone analysis(if available).
7. Biochemical and radioisotope kidney function tests.
8. Retrograde ureteropyelography, ureteropyeloscopy, pneumopyelography.
9. 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 are not fully understood, surgical removal of a kidney stone does not mean the patient’s recovery.

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

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

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

Stone elimination methods:

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

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

The emerging minimally invasive and minimally traumatic methods of treating urolithiasis have radically changed the mentality of an entire generation of urologists, the distinctive feature of which today is that regardless of the size and location of the stone, as well as its “behavior,” the patient should and can be rid of it! And this is correct, since even small, asymptomatic stones located in the calyces must be eliminated, since there is always a risk of their growth and the development of chronic pyelonephritis.

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

Diet for urolithiasis

The diet of patients with urolithiasis includes:

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

Physiotherapy for urolithiasis

Complex conservative treatment of patients with urolithiasis includes the appointment of various physiotherapeutic methods:

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

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

Sanatorium-resort treatment for urolithiasis

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

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

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

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

Treatment at 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 Tib-2 mineral water ( North Ossetia) with a therapeutic and prophylactic purpose 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).

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

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

Treatment of calcium oxalate stones

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

prevention of stone formation recurrence;
prevention of the growth of the stone 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 usually lasts 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;
Hypothiazide - 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 stone formation recurrence;
prevention of the growth of the stone 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 usually lasts 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 - in the presence of infection;
Magnesium oxide or aspartate - up to 1 month;
Hypothiazide - up to 1 month;
Herbal medicines (plant extracts) - up to 1 month;
Boric acid - up to 1 month;
Methionine - up to 1 month.

Treatment of cystine stones

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

prevention of stone formation recurrence;
prevention of the growth of the stone 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 usually lasts 1 month. Depending on the results of the examination, treatment may be resumed.

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

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

Complications of urolithiasis

Prolonged standing of 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.

The most common complications of urolithiasis are:

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

Lifestyle:

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

Increasing fluid intake:

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

Calcium intake.

Higher calcium intake reduces oxalate excretion.

Fiber consumption.

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

Oxalate retention.

Low levels of dietary calcium increase oxalate absorption. When dietary calcium levels increased to 15–20 mmol per day, urinary oxalate levels decreased. Ascorbic acid and vitamin D may contribute to increased oxalate excretion.
Indications: hyperoxaluria (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 of up to 4 g per day can occur without the risk of stone formation. Higher doses promote the endogenous metabolism of ascorbic acid to oxalic acid. This increases the excretion of oxalic acid by the kidneys.

Reducing protein intake:

Animal protein is considered one of the important factors risk of stone formation. Excessive intake 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 they reduce bone reabsorption. In addition, they increase the excretion of pyrophosphate and citrate, which increases the inhibitory activity of urine. Indications: hypercalciuria.
Complications:

diarrhea;
abdominal cramps;
nausea and vomiting.

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

Alkaline citrate:

Mechanism of action:

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

Indications: calcium stones, hypocitraturia.

Magnesium:

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

diarrhea;
CNS disorders;
fatigue;
drowsiness;

Magnesium salts cannot be used without using citrate.

Glycosaminoglycans:

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

Stones in the kidneys, ureter, and bladder are a problem that many patients who come to see a urologist learn about. Difficulty urinating, painful or mild pain in the abdomen, lower back, change in urine color is a reason to consult a doctor.

Why does urolithiasis develop in women? Symptoms and treatment of pathology, complications in advanced forms, types of stones, possible complications described in the article.

Causes

Pathology of the urinary system develops over a long period of time. Urologists pay attention to the complex impact of negative factors.

Poor nutrition bad habits, chronic pathologies increase the risk of calculus (stones) formation. Urolithiasis or urolithiasis actively develops with metabolic disorders, the influence of external and internal factors.

The main causes of urolithiasis:

violation of the acidity level of urine;
poor environment, low quality tap water;
the level of uric acid exceeds the norm (deviation shows a blood and urine test);
accumulation of harmful salts: phosphates, oxalates, carbonates;
chemical composition of soil and plants in the region of residence;
low physical activity;
violation of the principles of healthy eating, an excess in the menu of fried, spicy, salted foods, foods containing purines. Accumulation of salts of uric acid, excessive intake of calcium provokes the formation of urates, oxalates, phosphates;
infectious pathologies of the urinary system;
chronic diseases of the digestive system;
congenital pathologies of the kidneys and bladder;
prolonged immobility serious illness, after surgery with complications or injury;
improper production of hormones;
genetic disorders.

Types of stones:

oxalates;
urates;
phosphates.

Characteristic signs and symptoms

General signs of urolithiasis:

pain syndrome. The intensity of discomfort, the area of localization depends on the location of the focus of the disease;
problems with emptying the bladder;
nausea;
weakness;
renal colic;
vomit.

The location of the stones is easy to determine by the characteristic symptoms:

kidneys Aching, dull pain in the upper part of the lower back, blood in the urine, problems with urination. Discomfort increases when lifting weights, after working out in the gym;
ureter. The calculus disrupts the flow of urine and blocks the canal. Painful sensations appear in the groin area, hips, and genitals. When the stone is located in the lower part of the ureter, it seems to the patient that even after emptying the bladder is full, but the next attempt to urinate ends with a minimal release of fluid. Danger sign in women - renal colic. Sharp pain affects not only the abdomen, but also extends to the area of the hypochondrium, perineum, legs. The symptoms are similar to those of radiculitis and intercostal neuralgia;
bladder. The main symptom of the disease is frequent urge to urinate, discomfort increases after physical activity. Emptying the bladder is difficult, the urine becomes cloudy, sometimes blood clots are visible in the fluid.

Diagnostics

What tests should be taken to confirm or refute the diagnosis of "urolithiasis"? Doctors prescribe a comprehensive examination to clarify the size, area of localization of stones in the kidneys, bladder and ureter.

The patient submits:

blood analysis. Doctors are interested in the level of creatinine, uric acid and total protein;
general clinical urine analysis to clarify the level of red blood cells and white blood cells.

Diagnosis of urolithiasis:

survey urography to understand the size of the stone and the location of the stone;
excretory urography using a contrast agent;
Ultrasound examination (ultrasound) of the kidneys and bladder.

Urolithiasis code according to ICD - 10 - N20-N23.

General rules and methods of treatment

Main directions:

If you contact a specialist in a timely manner, the small size of the stones helps drug therapy and diet. During the procedures, the urologist crushes small, medium-sized stones on an outpatient basis;
at advanced cases urolithiasis is prescribed surgery, the choice of method is influenced by the size of the stones;
during the rehabilitation period, in the initial stage of the disease good effect gives herbal treatment in combination with taking medications;
additionally prescribed physical therapy(physical therapy);
Mandatory elements of therapy are diet correction, cessation of alcohol and smoking, and moderate physical activity.

How to relieve pain during an attack

Helpful Tips:

The first and mandatory condition is to call an ambulance;
relief of dangerous symptoms is carried out in a hospital setting;
Before the doctors arrive, you need to give the patient an antispasmodic tablet. Drotaverine, No-Shpa, Spazmalgon, Baralgin. Analgesics reduce pain: Codeine, Indomethacin, Paracetamol, Ketorol, Ketoprofen. It is necessary to strictly observe the dosage of painkillers;
doctors recommend giving drinking plenty of fluids. The water should be warm enough; ice-cold and hot drinks increase the load on the kidneys;
if there is doubt about the diagnosis, only painkillers and antispasmodics are allowed. Incorrect actions often worsen the patient's condition.

Warning! A hot heating pad on the lumbar area alleviates the condition. Doctors explain: this method is allowed only if you are sure that you are worried about an attack of renal colic. For pain with right side Inflammation of the appendix is possible; heat only accelerates the rupture of the appendix.

Medications

The urologist selects drugs for a complex effect on the tissues of the kidneys, ureter and bladder. Against the background of drug treatment, the strength of the inflammatory process decreases, the patient's condition improves. The smaller the stones, the easier it is to break them down and remove them from the body without serious discomfort.

Effective drugs:

To expand the lumen of the ureters, lower muscle tone, to reduce the severity of pain in urolithiasis is prescribed hormonal drugs. This type of medication can only be taken under the supervision of a specialist: self-medication for systemic use threatens serious complications.

Effective names:

Prednisolone.
Glucagon.
Progesterone.

To relieve spasms, reduce pain syndrome, antispasmodics and analgesics are prescribed:

Folk remedies and recipes

Herbal decoctions facilitate the release of sand and stones, reduce discomfort, and the strength of the inflammatory process. Fees from medicinal plants, fresh and dried fruits in the treatment of urolithiasis in women can only be consumed as prescribed by a urologist. To select the “right” herbs, it is important to take into account the size and nature of the stones: different salts require certain names for the preparation of herbal remedies.

The choice of plants depends on the type of stones:

urates. Parsley, St. John's wort, cranberries, horsetail, birch leaves, dill seeds;
oxalates. Corn silk, mint, horsetail, knotweed, strawberry leaves;
phosphates. Bearberry, parsley, lingonberry leaves, calamus root, St. John's wort.

Diet and rules of nutrition in case of illness

An incorrect diet and the predominance of foods that accelerate the formation of stones are one of the causes of problems in the organs of the urinary system. It is important to draw up a menu for urolithiasis under the guidance of an experienced doctor. Eating inappropriate types of food interferes with treatment and provokes the accumulation of urates, carbonates, and other types of salts.

Nutrition rules:

give up spicy, fried foods, do not eat pickles, smoked meats, ready-made sauces, forget about foods and drinks with dyes and preservatives;
steaming, baking - optimal methods of heat treatment of products;
meals - 4-5 times a day, after meals a leisurely walk is useful for better absorption of dishes;
per day you need to drink 2-2.5 liters of clean water;
beer, wine, strong alcohol are prohibited.

Go to the address and read about why your kidneys hurt and how to treat pain.

The diet for urolithiasis in women depends on the type of stones:

phosphates. Alkaline mineral waters, whole and skim milk, berries, cottage cheese, potatoes, green vegetables, and beans are not suitable. Hard cheese, pumpkin, and spices should also not be eaten. Healthy: parsley, grapes, pears, sauerkraut, vegetable oil, kefir. You can eat green apples and red currants;
urates. Products that increase uric acid levels are not suitable: veal, beef, poultry, fatty fish, offal. Not worth it large quantities there are eggs and grains. Dairy products, fruits, vegetables, juices, berries are healthy. Nutritionists recommend sweet apples, potatoes, melons, carrots, beets;
oxalates. It is important to reduce the level of calcium oxalate and reduce the acidity of urine. Doctors do not recommend consuming foods high in oxalic acid: cranberries, sorrel, citrus fruits, legumes. Mineral water and rosehip decoction are useful.

Outpatient procedures

Stone crushing is possible on an outpatient basis. The decision to perform minimally invasive procedures is made by the urologist based on the results of ultrasound, blood and urine tests. It is important to consider the size of the stones, general state patient.

Procedures for crushing and removing stones:

urethroscopy. During the session, the urologist crushes stones that interfere with the passage of urine, causing painful renal colic in women;
shock wave lithotripsy. The method is suitable for crushing stones up to 2 cm in size located in the upper part of the ureters. Larger lesions require anesthesia. The non-invasive procedure is the least traumatic and gives a positive result.

Physical exercise

Physical activity is one of the elements in the fight against the accumulation of harmful salts. During treatment and the rehabilitation period, moderate exercise is useful. The doctor prescribes special gymnastics - exercise therapy. The complex is designed so as not to overload the body, but to work out the necessary departments.

Useful exercises:

for stretching;
for the abdominals, buttocks and thighs;
for back muscles;
swimming;
walking;
a ride on the bicycle;
skiing;
general strengthening exercises.

On a note! It is useful to take a knee-elbow position for a third of an hour every day. During exercise, the outflow of fluid from the lower part of the kidneys improves.

Surgical intervention

With low effectiveness of therapy in an outpatient setting, large stone size, high risk of complications due to advanced stages For urolithiasis in women, surgical intervention is performed.

Types of operations:

percutaneous nephrolithotomy. The optimal method using endoscopic instruments. Through a puncture in the kidney, the doctor removes the hard formation;
laparoscopy in the kidney area. The method is used if the stones are so large that other types of operations are difficult to perform. IN abdominal cavity the doctor inserts a video camera and several instruments, and after removing the stones, the ureter is sutured. Average term hospital stay - up to four days.

Prevention of urolithiasis

refusal of alcoholic beverages and cigarettes;
proper nutrition;
control of metabolic processes;
weight correction if you have extra pounds;
limited consumption of protein foods;
physical education (without heavy loads);
normalization of mental balance;
regular (every two to three months) visits to the urologist.

In case of urolithiasis in women, one should not tolerate attacks of renal colic, take analgesics uncontrollably, or delay the start of therapy. Important to remember: If the stones are large, surgical intervention and a serious process of treatment and rehabilitation are required. In advanced forms of urolithiasis, it is possible dangerous complications, including the most difficult thing - the death of a kidney.